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目的探讨Pirh2 mRNA,Her-2,VEGF,MVD及TNF-α等因素在Ⅰ,Ⅱ期乳腺癌中劣性生物学行为的意义。方法随机选取湘雅医院乳腺科近10年间获得随访的Ⅰ,Ⅱ期(按2003年AJCC的TNM分期)女性乳腺癌87例,应用原位杂交法检测癌组织中的Pirh2 mRNA的表达;免疫组化SABC法检测Her-2,VEGF,MVD和TNF-α的表达。结合临床病理参数,采用多因素Cox比例风险模型分析Pirh2 mR-NA,Her-2等对乳腺癌预后的影响。结果术后5年内出现远处转移者40例(A组),无瘤生存5年以上者47例(B组)。A组中Pirh2 mRNA的表达(57.5%)明显高于B组(21.3%)(P=0.0009)。Pirh2 mRNA表达与Her-2无相关性,(r=0.020,P=0.856)。Kaplan-Meier的生存分析显示:Pirh2 mR-NA,Her-2,VEGF,MVD和TNF-α阳性表达以及腋窝淋巴结阳性患者的预后比阴性患者明显为差(均为P<0.05)。多因素Cox回归模型分析提示Pirh2 mRNA,Her-2,VEGF,MVD和TNF-α为Ⅰ,Ⅱ期乳腺癌的独立预后因素。结论Ⅰ,Ⅱ期乳腺癌患者的Pirh2 mRNA,Her-2,VEGF和TNF-α等呈阳性表达,提示预后差。
Objective To investigate the significance of poor biological behavior of Pirh2 mRNA, Her-2, VEGF, MVD and TNF-α in stage Ⅰ and Ⅱ breast cancer. Methods 87 cases of female breast cancer in stage Ⅰ and Ⅱ (according to the TNM stage of AJCC in 2003) were randomly selected in Xiangya Hospital for the past 10 years. The expression of Pirh2 mRNA in cancer tissues was detected by in situ hybridization. The expressions of Her-2, VEGF, MVD and TNF-α were detected by SABC method. Combined with clinicopathological parameters, multivariate Cox proportional hazards model was used to analyze the effect of Pirh2 mR-NA and Her-2 on the prognosis of breast cancer. Results 40 patients (group A) distant metastasis within 5 years after operation, 47 patients survived for more than 5 years (group B). The expression of Pirh2 mRNA in group A (57.5%) was significantly higher than that in group B (21.3%) (P = 0.0009). There was no correlation between Pirh2 mRNA expression and Her-2 (r = 0.020, P = 0.856). Kaplan-Meier survival analysis showed that the prognosis of patients with Pirh2 mR-NA, Her-2, VEGF, MVD and TNF-α positive expression and axillary lymph node positive was significantly worse than that of negative patients (all P <0.05). Multivariate Cox regression analysis revealed that Pirh2 mRNA, Her-2, VEGF, MVD and TNF-α were independent prognostic factors for stage I and II breast cancer. Conclusion The positive expression of Pirh2 mRNA, Her-2, VEGF and TNF-α in patients with stage Ⅰ and Ⅱ breast cancer suggest that the prognosis is poor.