摘要目的 探讨不同乳腺组织中Fascin-1蛋白的表达及其在乳腺癌发生发展中的临床病理意义.方法 采用免疫组织化学EnVision法检测2007年3月至2011年12月间的23例正常乳腺组织、69例乳腺良性病变、58例普通型导管增生(UDH)、61例导管原位癌(DCIS)、221例浸润性乳腺癌组织中Fascin-1蛋白的表达情况.结果 (1)正常乳腺组织、乳腺良性病变、UDH、DCIS、乳腺癌组织中Fascin-1的蛋白表达阳性率分别为100.0％(23/23)、89.9％(62/69)、13.8％(8/58)、19.7％(12/61)、42.1％ (93/221).乳腺正常和良性病变组织中Fascin-1蛋白的阳性率显著高于UDH、DCIS和乳腺癌组织(P＜0.01);乳腺癌组织中Fasein-1的阳性率显著高于DCIS和UDH(P ＜0.01);DCIS比UDH的Fascin-1阳性率有增高趋势,但差异无统计学意义(P＞0.05);Fascin-1在DCISⅢ级中的阳性率(26.8％,11/41)显著高于DCIS Ⅰ～Ⅱ级(1/20,P＜0.05).(2)乳腺癌中Fascin-1蛋白表达在＞3个腋窝淋巴结转移(P＜0.05)、更高的组织学分级和临床分期(P＜0.01)、雌激素受体和孕激素受体阴性表达(P＜0.01)的患者中显著增强.Logistic回归模型多因素分析显示Fascin-1的表达与乳腺癌患者临床分期升高呈正相关(OR=1.568,95％ CI=1.029 ～2.387,P＜0.05),与雌激素受体表达呈负相关(OR=0.149,95％ CI =0.079 ～0.2811,P＜0.01).结论 Fascin-1在乳腺正常和良性病变组织中高表达,提示其可能是乳腺成熟导管上皮的一个生物学标志物.Fascin-1蛋白的表达自UDH、DCIS至浸润性乳腺癌呈显著增高趋势,提示其在乳腺癌发生发展的全过程中均起了重要作用,有望成为抗乳腺癌治疗的一个潜在生物学标志物.

abstractsObjective To study the expression of fascin-1 protein in breast cancer and to evaluate its correlation with clinicopathologic features of the tumor.Methods Immunohistochemical EnVision method was performed to evaluate the expression of fascin-1 in 23 cases of normal breast tissues,69 cases of benign breast lesions,58 cases of usual ductal hyperplasia (UDH),61 cases of ductal carcinoma in situ (DCIS) and 221 cases of breast cancer from March 2007 to December 2011.Results Fascin-1 protein expression rates in normal breast tissues,benign breast lesions,UDH,DCIS and breast cancer were 100.0％ (23/23),89.9％ (62/69),13.8％ (8/58),19.7％ (12/61),and 42.1％ (93/221),respectively.Fascin-1 expression in normal breast tissues and benign breast lesions was significantly higher than those in UDH,DCIS and breast cancer (P ＜ 0.01) ; Fascin-1 expression in breast cancer was significantly higher than those in UDH and DCIS (P ＜ 0.01).There was a tendency of increased fascin-1 expression in DCIS compared to UDH,but the difference was not statistically significant (P ＞ 0.05).Fascin-1 positive rates in patients with DCIS grade Ⅲ (26.8％,11/41) was significantly higher than that in patients with DCIS grade Ⅰ-Ⅱ (1/20,P ＜ 0.05).Fascin-1 protein expression in breast cancer increased with increasing histologic grade and clinical stage (P ＜ 0.01).Fascin-1 protein expression was also significantly higher in tumors with negative estrogen receptor (ER) and progestone receptor (PR) status and ＞ 3 axillary lymph node metastases compared to tumors that were ER and PR positive and ≤3 axillary lymph node metastases (P ＜ 0.01 and P ＜ 0.05,respectively).Logistic regression analysis showed that fascin-1 expression correlated positively with high clinical stage (OR =1.568,95％ CI =1.029-2.387,P ＜ 0.05),but negatively with ER expression (OR =0.149,95％ CI =0.079-0.281,P ＜ 0.01).Conclusions Fascin-1 is highly expressed in normal breast tissues and benign breast lesions,suggesting that it may be a biological marker of mature mammary ductal epithelium.Fascin-1 protein expression shows a significantly increasing trend from UDH,DCIS to invasive breast cancer,suggesting that fascin-1 plays an important role in breast carcinogenesis and may be a potential target for therapy.