摘要目的 探讨骨髓微转移状况与乳腺癌临床病理学指标、生物学因子及预后的关系.方法 采用RT-PCR法检测乳腺癌骨髓组织中人乳球蛋白(hMAM)mRNA表达;免疫组织化学SP法检测乳腺癌组织中雌激素受体(ER)、孕激素受体(PR)及血管内皮生长因子(VEGF)的表达.结果 102例Ⅰ～Ⅲ期乳腺癌患者骨髓组织hMAM mRNA表达阳性率38.2%.骨髓微转移率随乳腺癌肿块的增大而增高(P=0.000);骨髓微转移与淋巴结转移状况相关(P=0.001);临床分期越晚,骨髓微转移率越高(P=0.001);组织学分化越差,骨髓微转移率越高(P=0.001);浸润性导管癌和浸润性小叶癌的骨髓微转移率较低度恶性乳腺癌组高(P=0.032).乳腺癌组织ER蛋白表达阴性组中,骨髓hMAM mRNA表达率高(P＜0.05).乳腺癌患者骨髓hMAM阳性者易发生远处转移(P=0.009).结论 乳腺癌骨髓微转移与癌组织中某些生物学因子有一定相关性;微转移阳性者发生远处肿瘤转移的概率高,预后差;骨髓微转移检测可以作为判断乳腺癌预后的指标之一.

abstractsObjective To investigate the relationship between bone marrow micrometastasis of patients with breast cancer and clinical pathological parameters, some molecular markers as well as prognosis.Methods The expression of hMAM mRNA in BM of patients with breast cancer was detected by RT-PCR.The expressions of ER, PR in cancer tissues were detected by immunohistochemical SP method. Results About 38.2 % positive expression rate of hMAM mRNA in 102 patients with stage Ⅰ -Ⅳ breast cancer was found.The expression of hMAM increased more in patients with T2-3 (＞2 cm) tumors than T1 (≤2 cm) (P =0.001)and with stage Ⅱ ,Ⅲ than stage Ⅰ (P =0.001). The expression of hMAM in the BM of breast cancer with grade I was lower than that of grade Ⅱ or Ⅲ (P =0.014). The expression of hMAM in the BM was related to the pathological type (P =0.032) and the axillary lymph node metastasis (P =0.001). The expressions of hMAM in BM were much higher with ER negative in breast cancer tissues (P ＜0.05). There was a correlation between patients with positive expression of hMAM in BM and distant metastasis (P =0.009). Conclusion The micrometastasis in BM is correlated with some clinical pathological parameters and some tumor markers. The patients with positive expression of hMAM in BM have more chances with distant metastasis and poor prognosis. The detection of micrometastasis may be as one of targets to predict the prognosis of breast cancer.