The Analysis Of Prognostic Value Of Nm23-H₁,C-erbB-2,and Cyclin E Protein In Breast Carcinoma

Objective: The aim of this study was to determine the expression of nm23-H1, C-erbB-2 and Cyclin E in breast cancer in relation to the parameters and prognosis. Methods: Took 80 cases from Human Tumor Hospital from January 1996 to December 2000 randomly, maked out their survival time by investigations. All were female, one side, and their age were from 26-70, the middle age was 46. Their clinical stage wasâ… stage(12),â…¡stage(43),â…¢stage(16),â…£stage(9) according to UICC clinical stage standand. All cases were operated and were tested by pathologic diagnosis. All material were perfected. The last observed time were on 31 December 2004. All statistics analysis was used SPSS 12.0 for window, single factor was used x2 test to analyze prognostic factors in breast carcinoma, Kaplan-Meier method and Cox proportional hazard model were used to analyze the relationship of their expression with prognosis. Expression of nm23-H1,C-erbB-2 and Cyclin E in 80 patients were determined by S-P immunohistochemical method, the relationship of three protein expression and the parameters and prognosis were analyzed. Results: (1) The expression rate of nm23-H1 was 57.5%, and was in connection with tumor size, TNM stage, the axillary lymph node status, and distant metastasis; the expression rate of C-erbB-2 was 41.2%, and was associated with age, menstruation status, tumor size, TNM stage, and axillary lymph node status; the expression rate of Cyclin E was 44.2%. Cyclin E positive expression was associated with TNM stage and axillary lymph node status. (2) the expression of nm23-H1 was negatively associated with that of C-erbB-2 protein (P<0.01)and Cyclin E protein (P<0.01), the expression of C-erbB-2 was positively associated with that of Cyclin E protein: (3) the results of survival analysis with Kaplan-Meier method showed the better overall survival time in the patients with nm23-H1 expression or Cyclin E positive expression than those without (P<0.01), negative C-erbB-2 expression exhibited a significantly better prognosis than positive C-erbB-2 expression (P<0.01), in multivariate Cox regression analysis, the expression of nm23-H1,C-erbB-2,and TNM stage were three important prognostic factors of breast carcinoma. The hazard ratios of nm23-H1, C-erbB-2 expression, and TNM stage were 0.395,1.446,and 2.009 respectively. (4) The patients whose survival time were less than five years had the largest positive expression of C-erbB-2 (66.67%); The patients whose survival time were more than five years had the largest positive expression of nm23-H1 (91.14%). (5) In one factor analysis ,the survival time was associated with menstruation, tumor size, TNM stage, the axillary lymph node state, distant metastasis significantly. (6) The positive expression of nm23-H1 had better prognosis in multivariate Cox regression analysis, the expression of nm23-H1, could be an independent prognosticator .The hazard ratios of nm23-H1 was 0.395. The positive expression of C-erbB-2 had worse prognosis. multivariate Cox regression analysis, the expression of C-erbB-2 could be independent prognosticator, The hazard ratios of C-erbB-2 was 2.009. In one factor analysis , the positive expression of Cyclin E had better prognosis, multivariate Cox regression analysis, In traditional prognostic factors, the TNM stage could be an independent prognosticator, The hazard ratios of the TNM stage was 1.446. Conclusions: In breast carcinoma, the expression of nm23-H1, C-erbB-2, and TNM stage could be an independent prognosticator, which would be helpful in selecting the high risk cases for further treatment, the expression of Cyclin E could not be an independent prognosticator.