GATA结合蛋白3在非特殊型浸润性乳腺癌组织中的表达及其与预后的关系
Expression of GATA binding protein 3 in non specific type invasive breast cancer and its relationship with prognosis of patients
摘要目的:探讨GATA结合蛋白3(GATA binding protein 3,GATA-3)在非特殊型浸润性乳腺癌患者癌组织中的表达及与患者预后的关系。方法:收集北京市垂杨柳医院2013年1月至2017年12月收治的98例非特殊型浸润性乳腺癌患者的临床资料进行回顾性分析,采用病例对照研究,收集癌旁正常组织作为对照。采用免疫组织化学法检测非特殊型浸润性乳腺癌癌组织和癌旁正常组织中GATA-3的表达情况,分析GATA-3不同表达与非特殊型浸润性乳腺癌患者临床病理特征的关系及对患者预后的影响,并分析对GATA-3表达的影响因素。本研究采用的统计方法:计数资料采用χ 2检验。生存率采用Kaplan-Meier法进行分析,Long-rank法进行组间比较。采用Logistic回归进行多因素分析。 结果:非特殊型浸润性乳腺癌患者癌组织中GATA-3阳性表达率为61.2%(60/98),癌旁组织为86.7%(85/98),两者比较差异有统计学意义(χ 2=16.57, P<0.001)。非特殊型浸润性乳腺癌患者的年龄、肿瘤直径对GATA-3的表达比较差异均无统计学意义(均 P>0.05),组织学分级、TNM分期、淋巴结转移、雌激素受体、孕激素受体、人表皮生长因子受体2对GATA-3表达比较差异均有统计学意义(均 P<0.05)。Logistic回归分析结果表明,淋巴结转移情况( OR=2.628,95% CI为1.180~5.812, P=0.018)、TNM分期( OR=3.419,95% CI为1.067~7.565, P=0.041)、组织学分级( OR=1.540,95% CI为1.026~2.361, P=0.044)及人表皮生长因子受体2表达( OR=1.801,95% CI为1.067~3.221, P=0.048)为GATA-3表达的独立影响因素。GATA-3阳性表达患者3年无病生存率为80.0%,阴性表达者为57.9%,两组比较差异有统计学意义(χ 2=4.30, P=0.045)。GATA-3阳性表达患者3年生存率(86.7%)高于阴性表达患者(68.4%),两组比较差异有统计学意义(χ 2=3.99, P=0.046)。 结论:在非特殊型浸润性乳腺癌患者中癌组织与癌旁正常组织相比较,GATA-3的表达缺失,TNM分期、组织学分级、淋巴结转移、雌激素受体、孕激素受体、人表皮生长因子受体2与GATA-3的表达有关,GATA-3阳性表达提示患者预后较好,淋巴结转移、组织学分级、TNM分期及人表皮生长因子受体2表达为GATA-3表达的独立影响因素。
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abstractsObjective:To investigate the expression of GATA binding protein 3 (GATA-3) in non-specific type invasive breast cancer(IBC-NST) and its relationship with prognosis of patients.Methods:The clinical data of 98 patients with IBC-NST in Beijing Chuiyangliu Hospital from January 2013 to December 2017 were retrospectively analyzed. The normal tissues adjacent to the cancer were collected as the control group by case-control study. The expression of GATA-3 in cancer tissues and normal tissues adjacent to the cancer was detected by immunohistochemical method separately. The relationship between the different expression of GATA-3 and the clinical and pathological features and prognosis of IBC-NST was analyzed. In this study, the counting data were used χ 2 inspection. The survival rate was analyzed by Kaplan-Meier method and compared between groups by Long-rank method. Logistic regression was used for multivariate analysis. Results:The positive expression rate of GATA-3 was 61.2% (60/98) in cancer tissues and was 86.7% (85/98) in the normal tissues of IBC-NST. The difference was statistically significant (χ 2=16.57, P<0.001). There was no significant difference in the expression of GATA-3 between the patients with non special invasive breast cancer and the diameter of tumor (all P>0.05).There were significant differences in the expression of GATA-3 in histological grade, TNM stage, lymph node metastasis, ER, PR and HER2 (all P<0.05). Logistic regression analysis showed that lymph node metastasis ( OR=2.628, 95% CI 1.180-5.812, P=0.018), TNM staging ( OR=3.419,95% CI 1.067-7.565, P=0.041), histological grade ( OR=1.540,95% CI 1.026-2.361, P=0.044), and HER-2 positive expression ( OR=1.801,95% CI 1.067-3.221, P=0.048) were risk factors for GATA-3 negative expression. The 3-year disease-free survival rate of patients with GATA-3 positive expression was 80.0% and that of patients with GATA-3 negative expression was 57.9%. The difference between the two groups was statistically significant (χ 2=4.30, P=0.045). The 3-year survival rate of patients with GATA-3 positive expression (86.7%) was significantly higher than that of patients with GATA-3 negative expression (68.4%) and the difference was statistically significant (χ 2=3.99, P=0.046). Conclusion:Compared with the normal tissues adjacent to the cancer, the expression of GATA-3 was lost in cancer tissues of IBC-NST patients. TNM staging, histological grade, lymph node metastasis, ER, PR and HER-2 were related to the expression of GATA-3. The positive expression of GATA-3 suggest that the prognosis of patients was better. Lymph node metastasis, histological grade, TNM staging and HER-2 positive expression were the risk factors of GATA-3 negative expression.
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