p53蛋白、PCNA在合并2型糖尿病乳腺癌患者肿瘤组织中的表达及其意义

目的探讨p53、PCNA这两种肿瘤分子学指标在合并2型糖尿病乳腺癌患者肿瘤组织中的表达情况，并对其与2型糖尿病的关系及临床价值做出评判。方法合并2型糖尿病乳腺癌患者111例，对照非糖尿病乳腺癌组患者304例，取石蜡切片作p53、PCNA指标的免疫组化检测。并分析比较两组指标的阳性率及无复发转移生存率。结果在合并2型糖尿病组中，p53阳性比例69％（77／111），阴性31％（34／111），对照组P53阳性比例58％（177／304），阴性42％（127／304），两者在统计学上有差别（x2值4．254，P值0．039）；在合并2型糖尿病组中，PCNA阳性比例73％（82／111），阴性27％（29／111），对照组PCNA阳性比例76％（231／304），阴性24％（73／304），两者在统计学上无差别（x2值0．196，P值0．658）。又以Kaplan—Meier生存分析法比较了p53及PCNA阴性、阳性组间患者的无复发转移率，均示差异无统计学意义。结论p53突变型肿瘤在伴发糖尿病的乳腺癌患者中更常见，具有临床病理指标价值；在预后方面，尚未见到p53或PCNA具有预后因子的价值。

Expression of p53 and PCNA in tumor tissue of breast cancer patients with type-2 diabetes mellitus

Objective To investigate the expression of p53 and PCNA in the tumor of breast cancer patients with type 2 diabetes mellitus. Methods 111 breast cancer patients with type 2 diabetes mellitus who underwent surgery from July 1, 2002 to July 1, 2008 were analyzed retropectively. The expression of p53 and PCNA, measured by immunohistochemistry（IHC） were compared to the 504 patients without type 2 diabetes mellitus. And the recurrence free survival were analyzed by Kaplan - Meier curves. Results There was a statistically significant difference of p53 expression between the patients with type 2 diabetes mellitus and the non - ones （69% vs. 58%, P = 0. 039）. However, the difference of PCNA expression was failed to be observed between the two groups （76% vs 76%, P = 0. 658 ）. Furthermore, the survival analysis were compared between the different expression group of p53 and PCNA （positive and negative）. The recurrence free survival were not significantly different between p53 positive and negative patients, as well as the PCNA. Conclusion There were more patients with p53 positive in type 2 diabetes mellitus group, which might indicate the pathogenisis of breast cancer. However, if they exerted a prognostic effect on breast cancer patients need further study.