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目的钙敏感受体(calcium sensing receptor,CaSR)和三磷酸腺苷结合盒转运体基因2(ATP binding cassette transporter gene 2,ABCG2)与多种恶性肿瘤的发生、发展及预后密切相关,但关于两者与三阴性乳腺癌(thriple-negative breast cancer,TNBC)的关系少见报道。本研究旨在探讨CaSR和ABCG2在TNBC组织中的表达,分析评价其在TNBC高度恶性生物行为及临床预后的判断价值。方法收集2009-02-10-2011-12-30韶关学院医学院附属医院普通外科(67例)和韶关市第一人民医院乳腺外科(199例)收治的经病理确诊的乳腺癌患者266例为研究对象,其中62例(23.3%)TNBC患者为研究组,204例(76.7%)非三阴性乳腺癌(non-TNBC)患者为对照组,应用免疫组化SP法检测两组患者癌组织中CaSR、ABCG2阳性表达率。结果研究组CaSR、ABCG2阳性表达率(80.6%,71.0%)明显高于对照组(63.7%,52.5%),χ~2值分别为6.222和6.623,P值分别为0.013和0.010;研究组中CaSR、ABCG2阳性表达与患者的年龄、月经状态、肿瘤大小、病理分级及脉管癌栓等无明显关系,而与淋巴结转移、病理类型及TNM分期密切相关,P<0.05。Kaplan-Meier生存分析显示,在TNBC患者癌组织中CaSR、ABCG2阳性表达者中位生存期和累计生存率均低于阴性表达者,差异有统计学意义,Log-rank=28.881,P<0.001;Log-rank=41.657,P<0.001。结论 CaSR和ABCG2表达与TMBC的侵袭、恶性程度及淋巴结转移相关;CaSR和ABCG2可能成为TNBC患者预后判断的预测指标。
The purpose of calcium sensing receptor (CaSR) and adenosine triphosphate binding cassette transporter gene 2 (ABCG2) is closely related to the occurrence, development and prognosis of a variety of malignant tumors. However, Negative breast cancer (thriple-negative breast cancer, TNBC) relationship rarely reported. The aim of this study was to investigate the expression of CaSR and ABCG2 in TNBC tissues and to evaluate the value of CaSR and ABCG2 in determining TNBC’s high malignant biological behavior and clinical prognosis. Methods Totally 266 patients with pathologically diagnosed breast cancer who underwent general surgery (67 cases) at Shaoguan University Medical College Affiliated Hospital and breast surgery at First People ’s Hospital of Shaoguan City (199 cases) were recruited from 2009-02-10-2011-12-30. Sixty-two (23.3%) TNBC patients were in the study group and 204 (76.7%) non-TNBC patients were in the control group. Immunohistochemical SP method was used to detect the difference between the two groups CaSR, ABCG2 positive expression rate. Results The positive rates of CaSR and ABCG2 in study group were significantly higher than those in control group (63.7% and 52.5%, respectively) (χ ~ 2 = 6.222 and 6.623, P = 0.013 and 0.010, respectively) The positive expression of CaSR and ABCG2 had no significant relationship with age, menstrual status, tumor size, pathological grade and vascular tumor thrombus, but closely related with lymph node metastasis, pathological type and TNM stage (P <0.05). Kaplan-Meier survival analysis showed that the median survival time and cumulative survival rate of CaSR and ABCG2 positive patients in TNBC patients were lower than those in negative patients, the difference was statistically significant, Log-rank = 28.881, P <0.001; Log-rank = 41.657, P <0.001. Conclusion The expressions of CaSR and ABCG2 are correlated with the invasion, malignancy and lymph node metastasis of TMBC. CaSR and ABCG2 may be predictors of prognosis in patients with TNBC.