摘要目的 探讨空泡膜蛋白1(Vmp1)在乳腺浸润性导管癌(IDC)和含导管原位癌(DCIS)成分的IDC中的表达及其与预后的关系.方法 采用免疫组织化学SP法检测Vmp1在102例IDC(其中32例为含DCIS成分的IDC)中的表达和定位,并与其他多项临床病理参数进行比较分析.结果 Vmp1阳性着色部位为细胞质,阳性率为57.8％ (59/102),IDC中Vmp1的表达与不同组织学分级(x2=12.644,P =0.002)、pTNM分期(x2=11.987,P=0.001)、淋巴结状态(x2=9.341,P=0.002)、肿物最大径(x2=7.630,P=0.022)、诺丁汉预后指数(NPI;x2=15.561,P=0.000)密切相关.在32例含有DCIS成分的IDC病例中,Vmp1表达的阳性率在DCIS中为81.3％ (26/32)比其旁边的IDC中56.3％ (18/32)要高,且差异有统计学意义(x2=4.655,P=0.031).患者术后平均无瘤生存期81.2个月,5年总生存率为90.2％ (92/102),无瘤生存率为81.4％ (83/102).Vmp1的表达对无瘤生存曲线分布有明显影响,其中阴性者预后较差(x2=11.192,P=0.001),多因素分析显示Vmp1是一个保护因素,相对危险度＜1.结论 IDC组织中Vmp1的表达具有较好的估测预后价值,Vmp1阳性提示预后较好.

abstractsObjective To investigate the expression of vacuole membrane protein 1 (Vmpl) and its prognostic value in invasive ductal carcinoma (IDC) and concomitant ductal carcinoma in situ (DCIS) of the breast.Methods The expression and location of Vmp1 in the breast tissues from 102 patients with IDC and 32 concomitant DCIS were detected by immunohistochemical SP method,and the relationship with clinicopathologic parameters was analyzed.Results Vmp1 expression was observed in the cytoplasm of the cancer cells in 57.8％ (59/102) cases,and correlated with grade (x2 =12.644,P =0.002),pTNM stage (x2 =11.987,P =0.001),node status (x2 =9.341,P =0.002),tumor diameter (x2 =7.630,P =0.022) as well as Nottingham Prognostic Index (NPI;x2 =15.561,P =0.000).The expression of Vmp1 in concomitant DCIS was higher than that in IDC (81.3％ vs 56.3％ ; x2 =4.655,P =0.031).In this cohort,the mean disease-free survival was 81.2 months; the 5-year overall survival rate was 90.2％ (92/102) and the disease-free survival rate was 81.4％ (83/102).Vmp1 expression had significant influence on disease-free survival time,with Vmp1-negative patients showing poor prognosis (x2 =11.192,P =0.001).COX's proportional hazards regression model revealed that Vmp1 was a protective factor,with relative risk ＜ 1.Conclusions The detection of Vmp1 in IDC may be helpful for prognosis prediction; the patients with Vmp1 expression may have a better prognosis.