| Abstract:Objective:To study the expression of ER,PR,HER-2 gene and the relativity to biological behaviors among metastatic lymph nodes, non-metastatic lymph nodes and primary tumor in axillary lymph nodes of levelâ… ,â…¡,â…¢. Meanwhile studing the local recurrence, distant metastasis and survival aspects of correlation of metastatic lymph node and non-metastatic lymph nodes in the axillary lymph levelâ…¢and the lymph node dissection in clinical significance. Methods:A randomly selected 120 general surgery patient with breast cancer in our hospital without preoperative radiotherapy, chemotherapy and done a group of axillary lymph nodes in Pathological examination after the surgery (Axillary lymph nodes, which marked with pectoralis minor muscle, is divided into three groups levelâ… ,â…¡,â…¢),collected complete clinical and pathological data. Select 76 patients with axillary lymph node-metastatic by the pathological diagnosis of breast cancer diagnosed, using Immunohistochemical SP method to detected 76 cases of breast cancer to study the expression of ER,PR,HER-2 gene and the relativity to biological behaviors among metastatic lymph nodes, non-metastatic lymph nodes and primary tumor in axillary lymph nodes levelâ… ,â…¡,â…¢. At the same time for archiving 60 breast cancer cases with clinical pathologic axillary lymph node metastasis in accordance with No. pathological paraffin blocks and complete data; Follow-up in which the local recurrence, distant metastasis and survival aspects of correlation of the axillary lymph of levelâ…¢between node-metastatic and nods non-metastatic. Results:(1) overall the rate of ER,PR and HER-2 expressed positive in axillary lymph levelâ… ,â…¡,â…¢downward trend but no significant difference(P>0.05); the expressing in non-metastatic group was not clear and specific.(2)the expressing of ER and HER-2 in group of axillary lymph node-metastatic levelâ… was lower than the primary tumor, no significant difference between the two groups(P>0.05); the expressing of PR in axillary lymph levelâ… was higher than primary tumors, two groups have no significant difference(P>0.05); the rate of ER in primary tumors and axillary lymph node metastasis levelâ… change in total 18.3%, the rate of PR change in total 14.1%, HER-2 changes in the overall rate of 24%.(3)the expressing of ER,PR in axillary lymph node-metastatic level II was lower than the primary tumor, no significant difference between the two groups (P>0.05); the expression of HER-2 in axillary lymph node-metastatic levelâ…¡was lower than primary tumors, two groups have significantly differences(P<0.05); the rate of ER,PR in primary tumors and axillary lymph node metastasis change in total 18.2%, HER-2 changes in the overall rate of 25%, but the consistency of the expressing of HER-2 in primary tumors and lymph node-metastatic is more differente. (4) the expressing of ER and PR in axillary lymph node-metastatic level III was lower than primary tumor, there are differences between the two groups but no statistically significant, and the expression was not correlated between the two groups(P>0.05); the expression of HER-2 in axillary lymph node-metastatic level III was lower than primary tumors, two groups have significantly different(P<0.05); the expressing of ER and PR and HER-2 in axillary lymph node-metastatic and primary tumor has no obvious expression of change and consistency. (5) the expressing of ER in axillary lymph node-metastatic levelâ… ,â…¡,â…¢between two adjacent intervals are not statistically significant(P>0.05); The difference of PR-metastatic lymph nodes in interval levelâ… andâ…¡,levelâ…¡andâ…¢was not statistically significant(P>0.05), while the difference in interval of levelâ… andâ…¢was significant(P<0.05). Non-metastatic lymph node group for ER,PR expression is not the frequency of small-depth study. (6)the expressing of ER and PR was significantly correlated in the same breast cancer; the expression of HER-2 was negatively related with ER, PR.(7)the rate of 5 year distant metastasis and 5-year local recurrence for axillary lymph node-metastatic levelâ…¢cases were significantly higher than non-metastatic cases; 5-year survival rate was significantly lower than axillary lymph node non-metastatic of levelâ…¢; node-metastatic axillary lymph Levelâ…¢tips poor prognosis. Conclusion:(1) overall the expressing of ER,PR and HER-2 in axillary lymph node-metastatic levelâ… ,â…¡,â…¢downward trend but no significant difference, lymph node non-metastatic without evidence of the specific expression; which the metastasis rate in lymph node levelâ… ,â…¡,â…¢decreased and has statistically significant (P<0.05).(2)the expressing of ER,PR in breast primary tumor and axillary lymph node-metastatic group was not statistically significant, which suggest that the expression of ER,PR may be not associated with lymph node infiltration. the expression of ER,PR in the primary tumor and axillary lymph node-metastatic group has no significant inconsistency, but may be one of the factors to affect the endocrine treatment. Also may be due to the occurrence of breast cancer is a complex, multi-step process of evolution and multi-gene, multi-factor interaction results. (3)the expressing of HER-2 in primary tumor and axillary lymph node-metastatic has no significant inconsistency, but illustrate that the process of tumor metastasis in vivo in a mechanism leading to its malignant mutation.(4)although some inconsistent results may be due to immunohistochemistry and the limit of the number of samples, but we must still consider the ER,PR,HER-2 in axillary metastases in The exact position for recurrent or metastatic breast cancer clinical treatment and prognosis.(5)the expressing of ER and PR was significantly correlated in the same breast cancer; the expression of HER-2 was negatively related with ER,PR.(6)the node dissection of axillary lymph levelâ…¢is conducive to more accurate estimates of pathological stage and prognosis, which was beneficial to the comprehensive treatment after the guidance and indirectly reduce the recurrence rate and distant metastasis rate, increase the survival rate.
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