摘要
日的:研究生存素(Survivin)、人类表皮生长因子受体2(HER-2)、巨囊性病液体蛋白15(GCDFP15)、Yes相关蛋白(YAP)表达对乳腺癌患者术后复发转移的预测价值.方法:收集156例经乳腺癌改良根治术治疗的乳腺癌患者乳腺癌病理组织及癌旁正常组织,比较乳腺癌患者癌组织和癌旁正常组织Survivin、HER-2、GCDFP15、YAP蛋白表达情况;所有患者术后均随访2年,根据患者术后随访期间复发转移情况将其分为Ⅰ组(51例)和Ⅱ组(105例),统计两组一般资料,比较两组癌组织Survivin、HER-2、GCDFP15、YAP蛋白表达情况,分析乳腺癌患者术后2年内复发转移的影响因素及癌组织Survivin、HER-2、GCDFP15、YAP蛋白单一及联合检测对乳腺癌患者术后2年复发转移的预测价值.结果:癌组织Survivin、HER-2、GCDFP15阳性表达率高于正常组织,YAP阳性表达率低于正常组织(均P＜0.05).Ⅰ组低分化、临床分期Ⅲ期患者占比高于Ⅱ组(均P＜0.05).Ⅰ组癌组织Survivin、HER-2、GCDFP15阳性表达率高于Ⅱ组,YAP阳性表达率低于Ⅱ组(均P＜0.05).分化程度为低分化、临床分期m期及Survivin、HER-2、GCDFP15蛋白阳性表达均为乳腺癌患者术后2年内复发转移的独立危险因素(OR=2.092、1.992、2.059、1.815、1.857,均P＜0.05);YAP蛋白阳性表达为乳腺癌患者术后2年内复发转移的保护因素(OR=0.489,P＜0.05).癌组织Survivin、HER-2、GCDFP15、YAP蛋白联合预测乳腺癌患者术后2年复发转移的曲线下面积(AUC)值高于四者单独检测(均P＜0.05).结论:乳腺癌的发生与Survivin、HER-2、GCDFP15、YAP蛋白表达情况有关,且患者术后2年复发转移的发生与其分化程度、临床分期及Survivin、HER-2、GCDFP15、YAP蛋白表达情况有关,同时Survivin、HER-2、GCDFP15、YAP蛋白联合可有效提高对乳腺癌患者术后2年复发转移的预测价值.
Abstract
Objective:To study the predictive value of Survivin,human epidermal growth factor receptor 2(HER-2),giant cystic disease fluid protein 15(GCDFP15)and Yes-associated protein(YAP)expression in postop-erative recurrence and metastasis of breast cancer patients.Methods:The pathological tissues and normal tissues adja-cent to breast carcinoma of breast cancer in 156 patients with breast cancer treated by modified radical mastectomy were collected.The expression of Survivin,HER-2,GCDFP15 and YAP protein in cancer tissues and normal tissues adjacent to breast carcinoma of breast cancer patients were compared.All patients were followed up for 2 years after operation.According to the recurrence and metastasis of patients during the follow-up period,they were divided into the Ⅰ group(51 cases)and the Ⅱ group(105 cases).The general data of the two groups were statistically analyzed.The expression of Survivin,HER-2,GCDFP15 and YAP protein in cancer tissues of the two groups was compared.The influencing factors of recurrence and metastasis of breast cancer patients within 2 years after operation and the predictive value of single and combined detection of Survivin,HER-2,GCDFP15 and YAP protein in cancer tissues for recurrence and metastasis of breast cancer patients within 2 years after operation were analyzed.Results:The posi-tive expression rates of Survivin,HER-2 and GCDFP15 protein in cancer tissues were higher than those in normal tis-sues,and the positive expression rate of YAP protein was lower than that in normal tissues(all P＜0.05).The pro-portion of patients with poor differentiation and clinical stage Ⅲ in the Ⅰ group was higher than that in the Ⅱ group(all P＜0.05).The positive expression rates of Survivin,HER-2 and GCDFP15 protein in cancer tissues of the Ⅰgroup were higher than those in the Ⅱ group,and the positive expression rate of YAP protein was lower than that inⅡ group(all P＜0.05).Poor differentiation,clinical stage Ⅲ and positive expression of Survivin,HER-2 and GCD-FP15 protein were independent risk factors for recurrence and metastasis of breast cancer patients within 2 years af-ter operation(OR=2.092,1.992,2.059,1.815,1.857,all P＜0.05).The positive expression of YAP protein was a protective factor for recurrence and metastasis of breast cancer patients within 2 years after operation(OR=0.489,P＜0.05).The area under the curve(AUC)value of Survivin,HER-2,GCDFP15 and YAP protein combined in pre-dicting recurrence and metastasis of breast cancer patients 2 years after operation was higher than that of the four alone(all P＜0.05).Conclusion:The occurrence of breast cancer was related to the expression of Survivin,HER-2,GCDFP15 and YAP protein,and the occurrence of recurrence and metastasis 2 years after operation was related to the degree of differentiation,clinical stage and the expression of Survivin,HER-2,GCDFP15 and YAP protein.At the same time,the combination of Survivin,HER-2,GCDFP15 and YAP protein could effectively improve the predictive value of recurrence and metastasis 2 years after operation in breast cancer patients.
维普
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