The Expression And Significance Of COX-2、FAP-α、PTEN、 Survivin Protein In The Process Of Dcutal Carcinoma In Situ

Objectives：To assess the expression and significance of the COX-2、FAP-α、PTEN、Survivinprotein in atypical ductal hyperplasia(ADH)、ductal carcinoma in situ (DCIS)、ductalcarcinoma in situ with microinvasion (DCIS-MI)、invasive ductal carcinoma (IDC)， andanalyze the association of its expression with clinicopathological characteristics andprognosis of ductal carcinoma in situ。Methods：1.Immunohistochemical method was used to detect the expression of COX-2、FAP-α、PTEN、Survivin protein inADH group（51）、DCIS group（74）、DCIS-MI group（61） and IDC group（77）.2.The association of the expression of COX-2、FAP-α、PTEN、Survivin protein indifferent groups were analyzed with non-parameter test，χ2test；The relationship betweenthe expression of COX-2、FAP-α、PTEN、Survivin protein and the clinicopathologicalcharacteristics of ductal carcinoma in situ were also analyzed withχ2test；Multivariateanalysis was used to establish the risk model to forecast the microinvasion and invasion ofductal carcinoma in situ.Results：1.The expression of COX-2、FAP-α、PTEN、Survivin protein in ADH、DCIS、DCIS-MI and IDC：The expression of COX-2protein in ADH、DCIS、DCIS-MI、IDCwere5.88%、22.97%、27.87%、59.74%，There were differences statistically between ADHgroup and DCIS group、DCIS-MI group and IDC group（χ2=6.562，P＝0.010； χ2=13.935，P＝0）；The expression of FAP-α protein in ADH、DCIS、DCIS-MI、IDC were7.84%、22.97%、44.26%、70.13%，There were differences statistically betweenADH group and DCIS group、DCIS group and DCIS-MI group、DCIS-MIgroup and IDCgroup（χ2=4.944，P＝0.026；χ2=6.898，P＝0.009；χ2=9.394，P＝0.002）；The expressionof PTEN protein in ADH、DCIS、DCIS-MI、IDC were92.16%、71.62%、57.38%、40.26%,There were differences statistically between ADH group and DCIS group、DCIS-MI groupand IDC group（χ2=7.957，P＝0.005；χ2=3.997，P＝0.046）；The expression of Survivinprotein in ADH、DCIS、DCIS-MI、IDC were5.88%、16.22%、27.87%、60.04%， Therewere differences statistically between DCIS-MI group and IDC group（χ2=15.059，P＝0）.2.The relationship between COX-2、FAP-α、PTEN、Survivin protein andclinicopathological characteristics of ductal carcinoma in situ：The expression ofCOX-2、FAP-α、PTEN、Survivin protein were associated with pathological changes、nuclear grade、ER、HER-2、Ki-67of ductal carcinoma in situ，in addition，COX-2wasassociated with starting symptoms and lymph node metastasis，FAP-αwas associatedwith starting symptoms、lymph node metastasis and PR expression，PTEN was associatedwith starting symptoms and PR expression，Survivin was associated with lymph nodemetastasis.3.Establish the multivariate analysis model to forecast the prognosis of ductalcarcinoma in situ:Establish the multivariate analysis model to forecast the microinvasionand invasion of ductal carcinoma in situ.The model1was to explore the microinvasion riskof ductal carcinoma in situ，Logit（P1）=-3.605+3.769*nuclear grade-1.082*pathologicalchanges-2.381*FAP-α，P1≥0.5085，we predicted the risk of microinvasion was relativehigh，P1＜0.5085，we predicted the risk of microinvasion was relative low；The model2was to explore the invasion risk of ductal carcinoma in situ，Logit（P2）=-5.285+2.127*COX-2+2.362*FAP+3.405*PTEN+1.398*Survivin+1.127*HER-2，P2≥0.3743，we predicted the risk of invasion was relative high，P2＜0.3743，we predicted therisk of invasion was relative low.Conclusion： 1.The expression of COX-2、FAP-α、PTEN、Survivin protein were play an importantrole in the occurrence and development of breast cancer.2. The expression of COX-2、FAP-α、PTEN、Survivin protein were associated witha variety of clinical pathological features of ductal carcinoma in situ.It can help forecastthe prognosis of the ductal carcinoma in situ to detect the COX-2、FAP-α、PTEN、Survivin protein in ductal carcinoma in situ.3. A variety of data were used to establish the multivariate analysis model to forecast themicroinvasion of DCIS，and to forecast the invasion of DCIS or DCIS-MI，the model wasmeaningful to forecast the prognosis of DCIS and DCIS-MI.