背景:三阴性乳腺癌(TNBC)是一类异质性的肿瘤,大多表现为侵袭性,预后不良。与他们的攻击行为和对治疗的化学抗性有关,上皮间质转化(EMT)的概念已经出现。CD9和CD29蛋白与EMT相关,可能在TNBC进展中起作用。我们的目的是研究这些标志物与淋巴结转移的关系,肿瘤分级,增殖活性,和病人的生存。
方法:我们的队列包括66例未接受新辅助治疗的TNBC患者,26-81岁。病理肿瘤分期从pT1b到pT3,组织学分级从II到III,根据Bloom-Richardson系统.CD9,CD29,E-cadherin,波形蛋白,使用H评分对雄激素受体和Ki-67的表达进行半定量。在统计学上评估了与患者的临床病理参数和生存率相关的蛋白质表达。
结果:我们观察到与原发肿瘤相比,淋巴结转移中CD9的表达较低(P=0.021)。与没有癌症扩散的患者相比,有淋巴结转移的患者的原发性肿瘤中CD29的表达显着降低(P=0.03)。CD9和CD29蛋白表达均与乳腺癌特异性生存率(BCSS)无关。原发性肿瘤周围E-cadherin的低表达与BCSS恶化相关(P=0.038)。分级和淋巴结转移的存在均与BCSS没有显着关联。E-cadherin在外周的较低表达也与较高的Ki67(Rs-0.26)和波形蛋白(Rs-0.33)相关。
结论:CD9和CD29蛋白表达降低与淋巴结转移有关,然而,他们与生存的联系没有得到证实。原发性肿瘤周围E-cadherin的低表达与高增殖和低乳腺癌特异性生存率相关。
BACKGROUND: Triple-negative breast carcinomas (TNBC) are a heterogeneous group of tumors with mostly aggressive behaviour and poor prognosis. In association with their aggressive behavior and chemoresistance to treatment, the concept of epithelial-mesenchymal transition (EMT) has come to the fore. CD9 and CD29 proteins are associated with EMT and may play a role in TNBC progression. Our aim was to investigate association of these markers with the lymph node metastasis, tumor grade, proliferative activity, and patient survival.
METHODS: Our cohort consisted of 66 TNBC patients without neoadjuvant therapy, aged 26-81 years. The pathological tumor stages ranged from pT1b to pT3 and histological grades ranged from II to III, according to the Bloom-Richardson system. Immunohistochemical evaluation of CD9, CD29, E-cadherin, vimentin, androgen receptor and Ki-67 expression was performed semiquantitatively using the H-score. Expression of the proteins was statistically evaluated in relation to the clinicopathological parameters and survival of the patients.
RESULTS: We observed lower expression of CD9 in lymph node metastases compared to the primary tumor (P = 0.021). The CD29 expression in primary tumor was significantly lower in patients with lymph node metastases compared to patients without cancer dissemination (P = 0.03). Neither CD9 nor CD29 protein expression was associated with breast cancer-specific survival (BCSS). Lower expression of E-cadherin at the periphery of the primary tumor was associated with worse BCSS (P = 0.038). Neither grade nor the presence of lymph node metastases reached significant association with the BCSS. Lower expression of E-cadherin at the periphery was also associated with higher Ki67 (Rs -0.26) and vimentin (Rs -0.33).
CONCLUSIONS: Decreased protein expression of CD9 and CD29 were associated with lymph node metastasis growth, however, their association with survival was not proved. Lower expression of E-cadherin at the periphery of the primary tumor was associated with high proliferation and poor breast cancer-specific survival.