The Expression Of PTEN, P16 And Nm23 And Their Prognostic In Carcinoma Of Breast

Objective To study the expression of growth suppressor gene PTEN, P16 and nm23 in carcinoma of breast, study the correlation between the expression of them and the clinical pathological indexes, as well as their prognosis in carcinoma of breast.Methods Immunohistochemical method (S-P) was applied to detect the expressions of PTEN, P16 and nm23 in 25 cases breast fibroadenoma and 50 cases carcinoma of breast (There were 24 patients whose auxiliary lymph nodes had been metastasized. The patients had been followed-up 60 months and it was found that 10 patients had died in 5 years) .The staining result was observed by using the optical microscope,then investigating the difference between corresponding groups by statistical methods.Results The high expression rate in carcinoma of breast (56% )of PTEN was statistically lower than that in fibroadenoma(80%). The positive expression rate in carcinoma of breast(48%)of P16 was statistically lower than that in fibroadenoma(88%) . The positive expression rate in carcinoma of breast (58%)of nm23 was lower than that in fibroadenoma(72%) ,but there was no Statistically significance(p > 0.05).In carcinoma of breast, the high expression rate of PTEN,the positive expression rate of P16 and nm23 were significantly associated with histologic grading. (p<0.01). The positive expression rate of P16 and nm23 were significantly associated with axillary lymph node metastasis (p<0.05) .The expression of PTEN and nm23 were significantly associated with TNM stage(p<0.01).The expressions of PTEN ,P16 and nm23 were all significantly associated with survival time of 5 years(p < 0.05).In Cox regression analysis, involvement of axillary lymph node,histologic gradeing,expression of PTEN and nm23 were four important prognostic factors of carcinoma of breast. The hazard ratios of histologic grading, anxillary lymph node, expression of PTEN and nm23 were 3.331, 4.706, 0.101, 0.179,respectively.The hazard degree could be lessen when the expression of PTEN was high and the expression of nm23 was positive.Conclusion The expression of tumor suppressor gene PTEN, P16 and nm23 in carcinoma of breast are lower than that in fibroadenoma .There is significant correlation between the expression of P16 and nm23 with cell differentiation and lymphatic metastasis in carcinoma of breast.PTEN plays an important protective role during the developing process of carcinoma of breast.PTEN and nm23 are really protective factors which could help to prolong patients' survival time. The COX regression analysis indicats that PTEN and nm23 are independent factors which are only secondary to histologic grading and axillary lymph node metastasis.They are important indexes which can be applied to judge the invasion and metastasis in carcinoma of breast.It could help to judge patients prognosis by jointly detecting the expression rate of PTEN, P16 and nm23 in carcinoma of breast.