摘要目的 研究间质细胞衍生因子1(SDF-1)及其受体CXCR4在浸润性乳腺癌中的表达,并分析其与浸润性乳腺癌相关临床病理指标及淋巴结转移之间的关系.方法 采用免疫组织化学LSAB方法检测SDF-1/CXCR4在120例浸润性乳腺癌中的表达情况;采用地高辛标记的寡核苷酸探针进行原位杂交以检测趋化因子SDF-1在肿瘤环境中表达的部位及来源.结果 (1)SDF-1主要表达于肿瘤细胞的胞质和胞膜;SDF-1的胞质表达在淋巴结阳性组高于阴性组(P=0.033),且其表达程度与淋巴结受累数目、病理学分期、组织学分级、肿瘤大小及ER表达等指标呈正相关(P<0.05);(2)罕见SDF-1 mRNA表达的脉管内皮却可见SDF-1蛋白的表达,其表达程度与肿瘤胞质SDF-1着色正相关(P<0.01);且淋巴管内皮SDF-1的着色与淋巴结转移程度为正相关(P=0.005);血管内皮SDF-1的着色与肿瘤环境中的淋巴细胞浸润正相关(P<0.01),且同时伴有较多淋巴细胞浸润及SDF-1血管内皮着色阳性的病例,其淋巴结的转移程度分别高于仅有上述条件之一或二者均不具备的各组病例(P<0.05);(3)CXCR4也主要表达于肿瘤细胞的胞质和胞核;CXCR4的胞质表达在淋巴结阳性组高于阴性组(P<0.05),且其表达程度与淋巴结受累数目、病理学分期、组织学分级、肿瘤大小及HER2表达等呈正相关(P=0.005),而胞核的表达仅与PR的表达情况呈正相关(P<0.01);(4)瘤细胞质CXCR4与SDF-1的表达呈正相关(P=0.001).结论 浸润性乳腺癌肿瘤细胞SDF-1和CXCR4的表达与多项临床病理指标,尤其是淋巴结转移率及转移程度有关,可作为预测乳腺癌淋巴结转移及预后的免疫病理学指标,同时应注意肿瘤微环境中SDF-1的多个来源及定位的不同意义.

abstractsObjective To study the expression of stromal cell derived factor 1 (SDF-1)/CXCR4 and their association with clinicopathologic features and lymph node metastasis in invasive breast carcinoma.Methods The expression of SDF-1 was studied by immunohistoehemistry and in-situ hybridization.Immunohistochemical study for CXCR4 was also performed. The correlation with various clinieopathologic parameters was analyzed. Results (1) SDF-1 was mainly expressed in tumor cells and the level of its expression (both membranous and cytoplasmic) in lymph node-positive group was higher than that in lymph node-negative group (P=0.033). Only cytoplasmic expression correlated with the number of positive lymphnode involved by metastasis, TNM tumor stage, histologic grade, tumor dimension and estrogen receptor status (P<0.05). (2) SDF-1 protein was also detected in the endothelial cells, although its mRNA was rarely detected. SDF-1 staining in lymphatics was associated with positive lymph node (P=0.005) and SDF-1 staining in blood vessels correlated with stromal lymphocytic reaction (P=0.001). The extent of nodal involvement was higher in the group with positive SDF-1 staining in blood vessels and with prominent lymphocytic reaction than that in other groups with one or neither of the two features (P<0.05). (3) On the other hand, CXCR4 was mainly expressed in tumor cells (both nuclear and cytoplasmic) ; and the level of its expression in lymph node-positive group was higher than that in lymph node-negative group (P=0.005). Only cytoplasmic expression correlated with the number of positive lymph node involved by metastasis, TNM tumor stage, histologic grade, tumor dimension and HER2 status (P<0.05). The nuclear expression of CXCR4 was only correlated with progesterone receptor status (P<0.01). The cytoplasmic expression CXCR4 also positively correlated with SDF-1 expression (P=0.001). Conclusions SDF-1 and CXCR4 can serve as biomarkers for diagnosis and prediction of lymph node metastasis, as well as potential therapeutic targets in invasive breast carcinoma. The difference in localization and staining patterns may also carry different significance.