乳腺癌组织中乳腺癌易感基因1、增殖细胞核抗原Ki-67表达的临床意义

目的 探讨乳腺癌组织中乳腺癌易感基因1（BRCA1）、增殖细胞核抗原Ki-67表达的临床意义.方法 采用免疫组织化学法检测194例乳腺癌病理组织标本BRCA1、Ki-67的表达情况,并对其与临床病理参数的相关性进行分析.结果 194例乳腺癌中,淋巴结阳性组、雌激素受体（ER）/孕激素受体（PR）阴性组和人表皮生长因子受体2（HER-2）阳性组的BRCA1低表达率较高（P＜0.05）,三阴组中BRCA1低表达率高于非三阴组（P＜0.05）;Ki-67高表达者多为组织分级较高、ER/PR阴性和HER-2阳性患者（P＜0.05）;且BRCA1和Ki-67具有负相关性（P＜0.05）,绝经后、组织分级低、淋巴结阳性、ER/PR阴性、HER-2阳性患者的BRCA1低表达合并Ki-67高表达所占比例较高（P＜0.05）,但在三阴组与非三阴组间差异无统计学意义.结论 联合检测BRCA1、Ki-67对乳腺癌的临床转归具有一定预测意义,尤其是BRCA1可作为三阴性乳腺癌的预后因素之一.

Clinical significance of BRCA1 and Ki-67 expression in breast cancer

Objective　To investigate the clinicopathologic features and prognostic significance of BRCA1 and Ki-67 expression in breast cancer. Methods　The expression levels of BRCA1 and Ki-67 were assayed by immunohistochemistry in 194 cases of breast cancer tissues. The correlations of BRCA1 and Ki-67 expression with patients' clinicopathologic features were also analysed. Results　Low expression of BRCA1 was detected in the lymph node metastasis group, ER/PR negative group, and HER-2 positive group in 194 patients with breast cancer (P < 0.05), as well as in the triple negative breast cancer (TNBC) group compared to non-TNBC group (P ＜0.05). High expression of Ki-67 was detected in patients with higher histological grade, negative ER/PR, and positive HER-2 (P < 0.05). Furthermore, negative correlation was found between the expression of BRCA1 and Ki-67 (P < 0.05). The combination of low expression of BRCA1 and high expression of Ki-67 was mostly found in the patients with postmenopausal, lower histological grade, lymph node metastasis, negative ER/PR and positive HER-2 (P < 0.05). However, there was no significant difference between TNBC and non-TNBC. Conclusion　Joint detection of BRCA1 and Ki-67 might play an important role in predicting clinical outcomes of breast cancer, especially BRCA1 may be one of prognostic factors in TNBC.