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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2013, Vol. 07 ›› Issue (04) : 260 -264. doi: 10.3877/cma.j.issn.1674-0793.2013.04.005

所属专题： 文献；

论著

孕激素受体a、b在乳腺浸润性导管癌中的表达及意义
黄泽楠1, 冯智英2, 刘宇1, 陈健宁2, 胡攀1, 潘宇航2, 刘仁斌1,†()   
  1. 1. 510630　广州，中山大学附属第三医院乳腺外科
    2. 510630　广州，中山大学附属第三医院病理科
  • 收稿日期:2012-09-01 出版日期:2013-08-01
  • 通信作者: 刘仁斌

Expressions of progesterone receptor a and b in breast invasive ductal carcinoma and their clinical significance

Ze-nan HUANG1, Zhi-ying FENG2, Yu LIU1, Jian-ning CHEN2, Pan HU1, Yu-hang PAN2, Ren-bin LIU1,†()   

  1. 1. Department of Breast Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2012-09-01 Published:2013-08-01
  • Corresponding author: Ren-bin LIU
  • About author:
    Corresponding author: LIU Ren-bin, Email:
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引用本文：

黄泽楠, 冯智英, 刘宇, 陈健宁, 胡攀, 潘宇航, 刘仁斌. 孕激素受体a、b在乳腺浸润性导管癌中的表达及意义[J/OL]. 中华普通外科学文献(电子版), 2013, 07(04): 260-264.

Ze-nan HUANG, Zhi-ying FENG, Yu LIU, Jian-ning CHEN, Pan HU, Yu-hang PAN, Ren-bin LIU. Expressions of progesterone receptor a and b in breast invasive ductal carcinoma and their clinical significance[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(04): 260-264.

目的

探讨孕激素受体a（PR-a）、孕激素受体b（PR-b）在乳腺浸润性导管癌（IDC）中的表达及其与各临床病理指标的相关性，探讨PR亚型与预后的关系。

方法

采用免疫组化法检测100例IDC组织中PR-a、PR-b的表达，分析其与雌激素受体α（ER-α）、雌激素受体β（ER-β）、人类表皮生长因子受体2（HER-2）、核增殖抗原Ki-67、淋巴结转移、细胞学分级、TNM分期及脉管癌栓的相关性，研究PR-a/PR-b比值与各指标的关系。

结果

PR-a阳性55例（55%），PR-b阳性58例（58%）。PR-a与HER-2、Ki-67的表达呈正相关（P < 0.05），与淋巴结转移负相关（P < 0.05），与ER-β及脉管癌栓负相关（P < 0.01），与ER-α、细胞学分级、TNM分期无相关；PR-b与淋巴结转移、细胞学分级、TNM分期负相关（P < 0.05），与HER-2、Ki-67及脉管癌栓亦呈负相关（P < 0.01），与ER-α、ER-β无相关。PR-a/PR-b>1者32例（48.5%），=1者18例（27.3%），< 1者16例（24.2%）。PR-a/PR-b > 1组的HER-2、Ki-67、高细胞学分级、高TNM分期、淋巴结阳性率高于PR-a/PR-b≤1组（P < 0.05）。

结论

PR-b的表达与HER-2、Ki-67、淋巴结转移、细胞学分级、TNM分期及脉管癌栓均呈负相关，而PR-a与各指标的相关性各不相同，PR-b阳性及PR-a/PR-b≤1可作为IDC预后良好的指标。

关键词: 浸润性导管癌, 孕激素受体a, 孕激素受体b, 预后
Objective

To investigate the expressions of progesterone receptor a and b in breast invasive ductal carcinoma(IDC) and their associations with clinical and pathological factors and prognosis.

Methods

The expressions of PR-a and PR-b in 100 specimens of IDC were detected by immunohistochemistry. The correlations between PR-a, PR-b and characteristics such as ER-α, ER-β, HER-2, Ki-67, axillary lymph node(ALN)metastases, cytological classification, TNM staging and lymphovascular invasion were analyzed, the relationships between PR-a/PR-b ratio and these factors were investigated.

Results

The expression rates of PR-a and PR-b were 55% and 58% respectively. The results showed positive correlation between PR-a and HER-2, Ki-67(P < 0.05), and negative correlation between PR-a and ALN metastases(P < 0.05), ER-β, lymphovascular invasion(P < 0.01), but irrelevant with ER-α, cytological classification, TNM staging. The results also showed that PR-b was negatively correlated with ALN metastases, cytological classification, TNM staging(P < 0.05), lymphovascular invasion, HER-2 and Ki-67(P < 0.01), although irrelevant with neither ER-α nor ER-β. The number of PR-a/PR-b > 1, =1 and <1 was 32(48.5%), 18(27.3%) and 16(24.2%) respectively. In PR-a/PR-b > 1 group, the positive rates of HER-2, Ki-67, high cytological classification, high TNM staging and ALN metastases were higher than PR-a/PR-b≤1 group(P < 0.05).

Conclusions

The expression of PR-b is negatively correlated with HER-2, Ki-67, ALN metastases, cytological classification, TNM staging and lymphovascular invasion. PR-b positive and PR-a/PR-b≤1 can be good indicators of prognosis for IDC.

Key words: Invasive ductal carcinoma(IDC), Progesterone receptor a(PR-a), Progesterone receptor b(PR-b), Prognosis
图1 乳腺浸润性导管癌PR-a、PR-b的表达（NovoLink Polymer检测法，400倍）
图2 PR-a与PR-b的差异性表达
表1 PR-a、PR-b与各指标的相关性[n/n(%)]（Spearman相关性分析）
? ER-α阳性 ER-β阳性 HER-2阳性 Ki-67阳性 淋巴结转移 细胞学分级Ⅲ级 TNM Ⅲ、Ⅳ期 脉管癌栓阳性
PR-a阳性 28/55(50.9) 19/55(34.5) 23/55(41.8) 35/55(63.6) 24/55(43.6) 21/55(38.2) 15/55(27.3) 5/55(9.1)
PR-a阴性 26/45(57.8) 28/45(62.2) 8/45(17.8) 19/45(42.2) 31/45(68.9) 26/45(57.8) 13/45(28.9) 14/45(31.1)
r值 -0.069 -0.276 0.259 0.214 -0.253 -0.195 -0.018 -0.279
P值 0.548 0.009 0.016 0.044 0.015 0.070 1.000 0.009
PR-b阳性 30/58(51.7) 28/58(48.3) 11/58(18.9) 21/58(34.5) 26/58(44.8) 22/58(37.9) 11/58(18.9) 5/58(8.6)
PR-b阴性 24/42(57.1) 19/42(45.2) 20/42(47.6) 33/42(78.6) 29/42(69.1) 25/42(59.5) 17/42(40.5) 14/42(33.3)
r值 -0.054 -0.03 -0.306 -0.42 -0.24 -0.214 -0.23 -0.311
P值 0.685 0.840 0.004 0.000 0.025 0.043 0.024 0.004
表2 PR-a/PR-b>1组与≤1组各指标阳性率的比较(χ2检验) [（%，n/n）]
PR-a/PR-b ER-α阳性 ER-β阳性 Ki-67阳性 HER-2阳性 脉管癌栓阳性 淋巴结转移 高细胞学分级(Ⅲ级) 高TNM分期(Ⅲ、Ⅳ期)
>1组 68.8(22/32) 50.0(16/32) 71.9(23/32) 46.9(15/32) 18.7(6/32) 65.6(21/32) 62.5(20/32) 46.9(15/32)
≤1组 35.3(12/34) 47.1 (16/34) 44.1(15/34) 20.6(7/34) 17.6(6/34) 35.3(12/34) 32.4(11/34) 14.7 (5/34)
χ2值 7.387 - 5.2 5.126 - 6.066 6.015 8.077
P值 0.008 1 0.027 0.036 1 0.026 0.026 0.007
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