Study On Expression Of Breast Cancer Related Proteins And Their Prognostic Significance

Objective:Retrospectively analyze the relationship between clinical parameters and prognosis of 214 stageâ… -â…¢resected breast cancer patients. Examine the value of related protein as prognostic factor and predictive factor for adjuvant chemotherapy in order to provide evidience for individual therapy.Methods:Collect the clinical data and survival information of 214 stageâ… -â…¢breast cancer patients who had been operated in general hospital of the People's Liberation Army from January 2000 to December 2004. Analyze the association between their clinical parameters, treatment and survival. Review the ER, PR, HER-2, Ki-67, EGFR, TOP II a, P53, bcl-2 and P170 immunohistochemical results, analyze the association of their expression and prognosis,discuss whether they can predict adjuvant chemotherapy efficacy. Examine the YB-1 protein expression of 185 breast cancer paients with immunohistochemical method, evaluate its prognostic significance.Results:Until Feb.28th 2010,214 cases were collected. The median follow up was 87 months. There are 48 patients loco-regional or distant relapse.The overall 5 year OS and DFS was 87.4%and 76.2%respectively. Cox multiple factors survival analysis suggest that age, axillary lymph node metastasis, SBR grade, adjuvant hormonal therapy are independent prognostic factors which are correlated with DFS. Lymph node-positive breast cancer patients benefit more from adjuvant chemotherapy, especially the patients who are premenopausal, with larger tumor size (more than 2 cm), hormone receptor-negative, HER-2 positive. Ki-67 expression is positively related to lymph node metastasis, SBR grade, vessel invasion, HER-2 status, negtively related to ER and PR. The patients with high Ki-67 expression (+>50%) can more likely benefit from adjuvant chemotherapy than low Ki-67 expression (+<50%). EGFR expression is tend to related to age and menopausal status. TOPâ…¡a is related to tumor size. bcl-2 expression is higher in patients with good SBR grade, positive hormonal receptors status, while P53 expression is higher in patients with poor SBR grade, positive HER-2 status. Y box binding protein 1 expression is higher in breast cancer tissue than normal breast tissue. There were significant correlations between the nuclear YB-1 expression and HER2, ER and PR. Ki-67+>25% is independent prognostic factor of DFS. There was no significant correlation between EGFR, TOP II a, P53, bcl-2, P170, nuclear YB-1 expression and DFS or OS.Conclusion:Age, lymph node metastasis, SBR grade, adjuvant hormone therapy is independent prognostic factor of DFS. Lymph node-positive breast cancer patients benefit more from adjuvant chemotherapy. Ki-67+>25% is independent prognostic factor of DFS. The patients with high Ki-67 expression (+>50%) are more likely benefit from adjuvant chemotherapy. Nuclear YB-1 expression is related to HER2, ER and PR, but it is not significant prognostic factor.