背景:乳房外Paget病(EMPD)是一种缓慢发展的恶性肿瘤,有时会进展到真皮的侵袭,全身性转移,和死亡。尽管有报道称真皮浸润与预后不良有关,到目前为止,还没有发现这种入侵的分子标记。这项研究的目的是确定预测EMPD真皮侵袭风险的关键分子。
方法:我们对三例原位EMPD进行了微阵列筛选,三例侵入性EMPDs,3例正常表皮。我们鉴定了表现出表达逐步增加的分子。Further,我们使用免疫组织化学染色(IHC)分析了47例EMPD,并检查了相关的临床病理发现,包括预后。
结果:我们检查了显示随侵袭逐步差异的分子。我们专注于转录因子激活增强子结合蛋白2B(TFAP2B)。在47例EMPD患者中,38(80.9%)和9(19.1%)的TFAP2B低表达和高表达,分别。TFAP2B的表达与真皮的侵袭密切相关,质量形成,术前淋巴结转移(p分别为0.001、0.042和0.033)。TFAP2B高表达组术后累积无复发率明显低于TFAP2B低表达组(P<0.001)。在无复发生存率的单因素分析中,发现TFAP2B表达是显著的因素(p=0.006)。
结论:TFAP2B的表达,这是通过微阵列筛选全面发现的,可能与EMPD的侵袭性相关,并且可能是不利的预后因素。
BACKGROUND: Extramammary Paget\'s disease (EMPD) is a slowly advancing malignancy that sometimes progresses to the invasion of the dermis, systemic metastases, and death. Although there have been reports that dermal invasion is associated with poor prognosis, no molecular markers of this invasion have been identified thus far. The aim of this study was to identify key molecules for predicting the risk of EMPD dermis invasion.
METHODS: We performed microarray screening for three cases of in-situ EMPDs, three cases of invasive EMPDs, and three cases of normal epidermis. We identified a molecule that exhibited a stepwise increase in expression. Further, we analyzed 47 cases of EMPD using immunohistochemical staining (IHC) and examined the correlated clinicopathological findings, including prognosis.
RESULTS: We examined molecules that showed stepwise differences with invasion. We focused on transcription factor activating enhancer-binding protein 2 B (
TFAP2B). Of the 47 EMPD patients, 38 (80.9 %) and 9 (19.1 %) had low and high
TFAP2B expression, respectively. TFAP2B expression was significantly correlated with invasion into the dermis, mass formation, and preoperative lymph node metastasis (p = 0.001, 0.042, and 0.033, respectively). The cumulative postoperative recurrence-free rate in the
TFAP2B-high expression group was significantly lower than that in the
TFAP2B-low expression group (P < 0.001). In univariate analysis of recurrence-free survival, TFAP2B expression was found to be a significant factor (p = 0.006).
CONCLUSIONS: The expression of
TFAP2B, which was comprehensively found by microarray screening, may correlate with the invasiveness of EMPD and may be an unfavorable prognostic factor.