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目的探索一种能准确地预测乳腺癌预后的分子分型系统。方法筛选7 0例乳腺癌标本,3 5例为诊断乳腺癌后5年内死亡者,另3 5例为存活超过10年者。两组在诊断和治疗等方面均相匹配。采用基于组织芯片的免疫组化技术检测两组标本中17个分子标志物的表达,采用聚类分析对17个标志物进行分组,对分组结果进行生存分析及临床病理参数相关分析。结果 17个标志物分为4个亚组:ERα相关组,增殖相关组,PR相关组和HER-2相关组,中位生存时间分别为1 4 2,1 2 6,8 8,7 7个月,差异均有显著性(P=0.0 4 4)。Cox模型分析4个亚组的生存时间,相邻两组间死亡风险平均增加了1.623倍。4个亚组与癌肿长径具有低度正相关(Cramer列联系数为0.3 7 7)。结论由ERα相关组,PR相关组,增殖相关组和HER-2相关组构成新的乳腺癌分子分型,可以准确地预测乳腺癌患者死亡风险,可作为乳腺癌预测预后的一种新分型方法。
Objective To explore a molecular typing system that can accurately predict the prognosis of breast cancer. Methods Totally 70 breast cancer samples were screened, 35 patients died within 5 years after diagnosis of breast cancer and 35 patients survived more than 10 years. Both groups matched in diagnosis and treatment. 17 immunohistochemical methods based on tissue microarray were used to detect the expression of 17 molecular markers in two groups of samples. Clustering analysis was used to group 17 markers. Survival analysis and clinicopathological parameters of the groups were analyzed. Results Seventeen markers were divided into four subgroups: ERα-related group, proliferation-related group, PR-related group and HER-2-related group. The median survival time was 14 2, 12 6, 8 8, Month, the difference was significant (P = 0.04 4). Cox model analysis of four sub-groups of the survival time, the risk of death between adjacent groups an average increase of 1.623 times. The 4 subgroups had a low positive correlation with the long diameter of the tumor (Cramer’s correlation coefficient was 0.3 7 7). Conclusion The molecular classification of breast cancer can be accurately predicted by ERα-related group, PR-related group, proliferation-related group and HER-2-related group, which can be used as a new classification for predicting the prognosis of breast cancer method.