摘要目的 观察上皮间质转化因子Twist转录因子(简称Twist)和相关蛋白E-和N-钙黏蛋白(cadherin)在乳腺癌中的表达及其与患者临床病理指标的关系.方法 采用免疫组织化学SP法检测56例浸润性导管癌、38例浸润性小叶癌和41例导管内癌以及10例正常乳腺组织中Twist、E-和N-cadherin的表达.结果 (1)三种病理类型乳腺癌组织中,Twist阳性率分别为46.4%(26/56)、79.0%(30/38)和26.8%(11/41),其中浸润性小叶癌中Twist阳性率显著高于浸润性导管癌和导管内癌(分别P=0.002、0.000);E-cadherin阳性率分别为78.6%(44/56)、29.0%(11/38)和80.5%(33/41),其中浸润性导管癌和导管内癌中E-cadherin阳性率显著高于浸润性小叶癌(均P=0.000);N-cadherin阳性率分别为53.6%(30/56)、68.4%(30/56)和31.7%(13/41),其中在浸润性导管癌和浸润性小叶癌中的阳性表达显著高于导管内癌(分别P=0.033、0.001).(2)135例乳腺癌组织中Twist和E-cadherin表达呈显著负相关性(P=0.005,Spearman相关系数-0.239);Twist和N-cadherin 表达呈显著正相关性(P=0.000,Spearman相关系数0.319).(3)乳腺浸润性导管癌差分化组中N-cadherin阳性率显著高于中分化和高分化组(P=0.004).(4)乳腺浸润性小叶癌淋巴结转移组中Twist阳性率显著高于淋巴结未转移组(P=0.037).结论 三种蛋白在三种乳腺癌组织中的表达差异较大.Twist阳性表达与乳腺浸润性小叶癌淋巴结转移相关.N-cadherin阳性率与乳腺浸润性导管癌组织学分级相关.检测这三个指标可为研究乳腺癌的进展和转移机制及评判其生物学行为提供有价值的参考.

abstractsObjective To investigate the expression of Twist,E-cadherin and N-cadherin in breast carcinoma tissue and to analyse their effects on the breast carcinoma differentiation, size, infiltration and metastasis of the breast carcinoma. Methods The expression of Twist, E-cadherin and N-cadherin in 56 cases of breast invasive ductal carcinoma,38 cases of invasive lobular carcinoma,41 cases of carcinoma in situ and 10 cases of normal breast tissue was detected using immunohistochemistry. Results ( 1 ) The expression rate of Twist in three types of breast carcinoma was 46. 4% (26/56) ,79. 0% (30/38) and 26. 8% (11/41) respectively, and the expression of Twist in invasive lobular carcinoma was significantly higher than that in invasive ductal carcinoma and carcinoma in situ (P = 0. 002, P = 0. 000 ). The expression rate of E-cadherin in three types of breast carcinoma was 78. 6% (44/56) ,29. 0% ( 11/38) and 80. 5% (33/41) respectively, and the expression of E-cadherin in invasive ductal carcinoma and carcinoma in situ was significantly higher than that in invasive lobular carcinoma (P = 0. 000, P = 0. 000). The expression rate of N-cadherin in three types of breast carcinoma was 53. 6% (30/56) ,68. 4% (26/38 ) and 31. 7% (13/41) respectively, and the expression of N-cadherin in invasive ductal carcinoma and invasive lobular carcinomawas significantly higher than that in carcinoma in situ ( P = 0. 033, P = 0. 001) . ( 2 ) In all the 135 cases, the expression of Twist was not correlated with that of E-cadherin ( P = 0. 005, Spearman correlation coefficient = - 0.239) , however, there was a positive correlation between the expression of Twist and N-cadherin and statistically significant(P = 0. 000, Spearman correlation coefficient =0.319). (3) In the invasive ductal carcinoma, the expression of N-cadherin in poorly-differentiated carcinoma was significantly higher than that of the moderately-or well-differentiated ones ( P = 0. 004 ). ( 4 ) In the invasive lobular carcinoma, the expression of Twist in cases with lymph node metastasis was significantly higher than that of cases without metastasis ( P = 0. 037 ). Conclusions Twist, E-cadherin and N-cadherin have different expression patterns in the three kinds of breast carcinoma. The positive expression of Twist was correlated to lymph node metastasis in invasive lobular carcinoma and the positive expression of N-cadherin was correlated to cell the tissue differentiation in invasive ductal carcinoma. Detection of the expression of these biomarkers may provide a valuable reference for the study of breast carcinoma progression, metastasis and for the judgment of the biological behavior of the carcinoma.