摘要目的 研究乳腺癌及癌旁增生组织中p16INK4a和视网膜母细胞瘤(RB)基因启动子区域的甲基化状况,并探讨基因异常甲基化与蛋白表达及其临床意义.方法 采用甲基化特异性PCR方法 对46例乳腺癌、22例癌旁增生组织及7例正常乳腺组织中p16INK4a和RB基因启动子区域甲基化状况进行检测,并采用免疫组织化学SP法对p16INK4a蛋白表达情况进行相应检测.结果 乳腺癌、癌旁增生组织和正常乳腺组织中p16INK4a基因的甲基化率分别为23.9%(11/46)、18.2%(4/22)、1/7;RB基因的甲基化率分别为10.8%(5/46)、9.1%(2/22)、0(0/7);肿瘤组织、癌旁增生组织和正常乳腺组织中p16INK4a基因、RB基因甲基化率差异均无统计学意义(P>0.05).正常乳腺组织、癌旁增生组织、乳腺癌中p16INK4a蛋白表达阳性率分别为7/7、60.8%(28/46)和81.8%(18/22),三者之间差异无统计学意义(P>0.05);肿瘤组织中p16INK4a蛋白表达与肿瘤分级相关(P<0.05);肿瘤组织中p16INK4a甲基化状况与其蛋白表达、肿瘤分级、ER表达阴性具有相关性(P<0.05),与肿瘤大小、淋巴结转移、年龄均不相关;RB基因甲基化状态与肿瘤分级、肿瘤大小、ER表达及年龄均无相关性,但与淋巴结转移相关(P<0.05).结论 p16INK4a基因异常甲基化可能在乳腺癌发生过程中作用有限,但在肿瘤的演进中发挥作用;RB基因甲基化检测对于分析乳腺癌进展及预后情况可能有一定参考价值;p16INK4a基因甲基化是p16INK4a蛋白失表达的机制之一.

abstractsObjective (1) To investigate the promoter methylation status of gene p16INK4a and gene RB in breast carcinoma and the adjacent non-neoplastic hyperplastic epithelial tissue. (2) To study the correlation of p16INK4a gene expression at protein level with the abnormal gene methylation, the clinical manifestation and the pathological parameters. Methods Methylation status of promoters of p16INK4a gene and RB gene was detected by using methylation specific PCR in 46 cases of breast cancer, 22 cases of the adjacent non-neoplastic hyperplastic epithelium tissue and 7 cases of normal breast tissue. In addition, the p16INK4a gene protein expression level was also detected using immunohistochemical technique(SP method) in 46 cases of breast cancer and 22 cases of the adjacent hyperplastic epithelial tissue. Results The methylation rate of p16INK4a gene was 23. 9% (11/46) in breast cancer, 18. 2% (4/22) in the adjacent non-neoplastic hyperplastic epithelial tissue and 1/7 in normal breast tissue, respectively. The methylation rate of RB gene was relatively low, which was 10. 8% (5/46) ,9. 1% (2/22) and 0(0/7) in the above 3 groups, respectively. Methylation rate of p16INK4a gene and RB gene was not significantly different among the breast cancer, the adjacent non-neoplastic hyperplastic tissue and the normal tissues (P >0. 05). However,the methylation status of p16INK4a gene was closely correlated with its protein expression level and the negative ER expression result of the breast cancer (P<0.05), but not correlated with the size of the cancer,differentiation status, lymph node metastasis, and age. The methylation status of RB gene was correlated with lymph node metastasis, but not with the size, the differentiation status, ER expression of the breast cancer and the age of the patients. Conclusions The abnormal methylation of p16INK4a gene may not play a significant role in the early stage of breast cancinogenesis, but may play a role of in the progression of the cancer. RB gene methylation may also be a indicator in choice to identify the progression and prognosis of breast cancer.