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摘要:
目的 实验研究表明非受体酪氨酸激酶(c-Src)与乳腺癌的转移密切相关, 本研究探讨c-Src表达在转移性乳腺癌中的预后价值。 方法 收集2007年1月至2010年10月102例转移性乳腺癌患者的原发癌组织蜡块, 免疫组化法检测c-Src的表达。回顾性分析c-Src表达与乳腺癌临床病理特征的关系、生存分析及Cox风险模型, 探讨c-Src表达对患者预后的影响。 结果 102例乳腺癌组织中c-Src表达率为54.9%, c-Src高表达于无进展生存期(PFS)≤3年(P=0.048)的患者。生存分析显示c-Src阳性较阴性的患者疾病特异性生存(DSS)显著缩短(P=0.017)。分层分析显示激素受体(HR)阳性/c-Src阳性患者DSS最短, 而HR阳性/c-Src阴性的患者DSS最长(P=0.016)。多因素分析显示, HR阳性/c-Src阳性、PFS≤3年、肿瘤组织学分级Ⅲ级和年龄≤35岁均是较差的DSS独立预测因子。 结论 转移性乳腺癌患者中, HR阳性且c-Src阳性预测患者的不良预后。 Abstract:Objective c-Src is reported to be critical for breast cancer progression.However, few reports have been published on the prognostic value of c-Src in breast cancer.The present study aims to explore c-Src expression and to evaluate its effects on the prognosis of metastatic breast cancer(MBC). Methods Paraffin-embedded primary tumor tissue sections from 102 MBC patients were collected consecutively from January 2007 to October 2010.Immunohistochemical staining was conducted to determine c-Src expression. Clinical data during the follow up after 7 to 143(median, 40) months after final diagnosis were analyzed in retrospect.Survival analysis and the Cox proportional hazards model were used to explore the prognostic value of c-Src expression in breast cancer. Results The c-Src expression rate in 102 MBC patients was 54.9%.The c-Src expression rate was significantly higher among breast cancer patients with a progression-free survival(PFS) of less than 3 years(P=0.048).The survival analysis clearly indicated that patients with positive c-Src expression had poor disease-specific survival(DSS) compared with those with negative expression(P= 0.017).The stratified analysis demonstrated that c-Src expression showed a significantly poor DSS(P=0.016) in estrogen receptor/ progesterone receptor-positive patients.No significant differences in DSS were observed(P=0.904) among HR-negative patients. The multivariate analysis indicates that HR+/c-Src+ expression and the histologic grading of tumors and age below 35 years are the independent predictors of DSS for MBC patients. Conclusion A positive hormone receptor plus HR+/c-Src+ expression predicts a poor prognosis in MBC patients. -
Key words:
- c-Src /
- Metastatic breast cancer /
- ER/PR /
- Prognosis
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图 2 c-Src阳性与阴性转移性乳腺癌患者的生存曲线
A：c-Src阳性与阴性患者的生存曲线；B：根据激素受体状态分层进行生存分析
Figure 2. Survival curves of the metastatic breast cancer patients with c-Src expression and those without c-Src expression
表 1 102例转移性乳腺癌原发癌组织c-Src表达与临床病理学参数的关系 例（%）
Table 1. Association between c-Src expression and clinicopathologic parameters in 102 metastatic breast cancer patients
表 2 单因素及多因素分析转移性乳腺癌患者的预后因素
Table 2. Cox regression analysis of the disease-specific survival of metastatic breast cancer patients
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