| Objective: Male breast cancer(MBC)is a rare clinical disease.PARP1,PKM2 expression in tumor cells has been studied,but not widely used in clinical.At present,the molecular typing and clinicopathological features of MBC are not clear.The purpose of our study is to explore the relationship between the expression of PARP1 and PKM2 in MBC and the molecular typing and clinical features.Methods: A total of 70 cases of primary male breast cancer specimens received from January 2006 to December 2016 in the Department of Pathology,Fourth Hospital of Hebei Medical University were retrospectively.Fifty-eight patients were enrolled in this study.58 cases of breast cancer patients as a control.The relationship between the age,tumor size,pathological type,histological grade,molecular typing,tumor thrombus and lymph node metastasis and PARP and PKM2 expression was detected by immunohistochemistry.The expression of PARP1 and PKM2 in male breast cancer was statistically analyzed by SPSS21.0 statistical software,and the difference was statistically significant by using chi-square test and Spearman rank correlation test.P<0.05 was statistically significant.Result:1 General Information:58 cases of male breast cancer patients were all surgical treatment,preoperative estrogen and progesterone therapy and radiotherapy and chemotherapy.The median age of the patients was 35 years and 79 years,with a median age of 62 years(mean age 61.3 years).Among them,44patients(6.90%)aged 44 and below were 17 patients(29.31%)aged 45 to59,More than 37 patients(63.79%).Lymph node metastasis: no lymphnode metastasis,32 cases(55.17%);lymph node metastasis,26 cases(44.83%),of which 1-3 positive lymph nodes,17 cases(29.31%);4-9positive lymph nodes,(8.62%);? 10 positive lymph nodes,4 cases(6.90%).TNM stage: ?,19 cases(32.76%);?,27 cases(46.55%);?,case 12(20.69%).Tumor diameter> 2cm,? 5cm,20 cases(34.48%);tumor diameter> 5cm,3 cases(5.17%).PT3 + pT4(> 5cm or skin invasion),6 cases(10.34%).Tumor pathologic types: invasive ductal carcinoma,46 cases(79.31%);the remaining 12 cases(20.62%).Histopathological grade: grade ?,3 cases(5.17%);grade ?,39 cases(67.24%);grade ?,16 cases(27.59%).The Pulmonary tumor thrombus:aortic thrombosis,17 cases(29.31%);no vascular suppository suppository,41 cases(70.69%).Nerve invasion: nerve invasion in 8 cases(13.79%),no nerve invasion in 50 cases(86.21%).Molecular classification: Luminal A type in 2 cases(3.45%),Luminal B type 54cases(93.10%),Her-2 overexpression in 2 cases(3.45%),three female type 0(0.00%).2 Follow-up results: follow-up as of January 31,2017 or patients died,followed up 58 patients,all into the group.Follow-up time was 2 to 128 months,with a median follow-up time of 34.5 months.3 Expression of PARP1 and PKM2 in MBC3.1 Analysis of Clinicopathological Parameters and PARP1 Expression in MBC3.1.1 Vascular nodules and PARP expression analysis: 36 cases(62.07%)of PARP1 positive expression without thrombosis,PARP1 positive expression of 15 cases(25.86%)of tubule thrombus,PARP1-negative expression in 5 cases(8.62%).There was no significant difference between the two groups(?2 = 3.130,P = 0.077).There was no significant difference between the two groups(?2 = 3.130,P = 0.077).3.1.2 Lymph node metastasis and PARP 1expression: no lymph node metastasis: PARP1 positive expression in 29 cases(50.00%),negative expression in 3 cases(5.17%);lymph node metastasis 1-3: PARP1 positive expression in 15 cases(25.86%),Negative expression of 2 cases(3.45%);lymph node metastasis 4-9: PARP1 positive expression of 3cases(%),negative expression in 2 cases(3.45%);lymph node metastasis? 10: PARP1 positive expression of 4 cases(%),Negative expression of0 cases(0.00%).The ?2 test,the difference was not statistically significant(?2 = 3.576,P = 0.302).3.1.3 Different histological grade and PARP1 expression analysis:histological grade ?,positive expression in 3 cases(5.17%),negative expression in 1 case(1.72%);histological grade ?,positive expression of 35 cases(60.35%),Negative expression in 4 cases(6.90%);histological grade ? grade,positive expression in 13 cases(22.41%),negative expression in 2 cases(3.45%).The ?2 test,the difference between the two groups was not statistically significant(?2 = 0.787,P =0.675).3.1.4 The expression of tumor diameter and PARP1: diameter ? 2cm:positive expression in 31 cases(53.45%),negative expression in 4 cases(6.90%);tumor diameter> 2cm,? 5cm: positive expression in 17 cases(29.31%),negative expression 3 cases(5.17%),negative expression of 0cases(0.00%);by ?2 test,the difference was not statistically significant(?2 = 0.937,P = 0.626)3.1.5 PARP1 positive expression in 18 cases(31.03%),negative expression in 1 case(1.72%);2: PARP1 positive expression in 24 cases(41.38%),negative expression of 3(5.17%);3 cases: PARP1 positive expression in 10 cases(17.24%),negative expression in 2 cases(3.45%).The ?2 test,the difference was not statistically significant(?2 = 2.693,P= 0.441).3.1.6 Luminal type B: PARP1 positive expression in 2 cases(3.45%),negative expression in 0 cases(0.00%);Luminal B type: PARP1 positive expression in 2 cases(3.45%),negative The expression of HER-2overexpression was 47(81.03%)in PARP1 and 7(12.07%)in negative expression.After ?2 test,the difference was not statistically significant(?2 = 1.069,P = 0.586).3.1.7 Nerve invasion and PARP1 expression analysis: no nerve invasion:PARP1 positive expression in 44 cases(75.86%),negative expression in6 cases(10.35%);nerve invasion: PARP1 positive expression in 8 cases(13.79%),Negative expression of 0 cases(0.00%).After ?2 test,the difference was not statistically significant(?2 = 0.919,P = 0.594).3.2 Analysis of Clinicopathological Parameters and PKM2 Expression in MBC3.2.1 The expression of PKM2 and the expression of PKM2: 35 cases(60.35%)were positive for pteris and PKM2;15 cases(25.86%)were positive for papilla and PKM2;(0.45%).There was no significant difference between the two groups(?2 = 0.000,P = 1.000).There was no significant difference between the two groups(P <0.05).3.2.2 lymph node metastasis and PKM2 expression: no lymph node metastasis: PKM2 positive expression in 27 cases(46.55%),negative expression in 5 cases(8.62%);lymph node metastasis 1-3: PKM2 positive expression in 15 cases(25.86%),Negative expression of 2 cases(3.45%);lymph node metastasis 4-9: PKM2 negative expression in 4cases(6.90%),negative expression in 1 case(1.72%);lymph node metastasis ?10: PKM2 positive expression in 4 cases(6.90%),Negative expression in 0 cases(5.17%);by ?2 test,the difference was not statistically significant(?2 = 0.918,P = 1.000).3.2.3 Different histological grade and PKM2 expression analysis:histological grade ?,positive expression in 3 cases(5.17%),negative expression in 0 cases(0.00%);histological grade ?,positive expression of 34 cases(58.62%),Negative expression in 4 cases(6.90%);histological grade ? grade,positive expression in 13 cases(22.41%),negative expression in 4 cases(6.90%).The ?2 test,the difference between the two groups was not statistically significant(?2 = 2.414,P =0.299).3.2.4(10.4%),tumor diameter> 2cm,? 5cm: PKM2 positive expressionin 18 cases(31.04),the expression of PKM2 was significantly higher than that of PKM2 %),Negative expression of 2 cases(3.45%);tumor diameter> 5cm: PKM2 positive expression in 3 cases(5.17%),negative expression of 0 cases(0.00%).The ?2 test,the difference was not statistically significant(?2 = 1.465,P = 0.481).3.2.5 There was no significant difference between the two groups(P>0.05).Conclusion: The expression of PKM2 and the expression of PKM2 in 15 cases(25.86%)and negative expression in 4 cases(6.90%);(1.72%);3 cases: PKM2 positive expression in 11 cases(18.97%),negative expression in 2 cases(3.45%).The ?2 test,the difference was not statistically significant(?2 = 5.751,P = 0.134).3.2.6 The expression of PKM2 was negative in 1 case(1.72%),negative expression in 1 case(1.72%);Luminal B type: PKM2 positive expression in 47 cases(81.03%),negative 7 cases(12.07%)were expressed;HER-2overexpression type: PARP positive expression in 2 cases(3.45%),negative expression of 0 cases(0.00%);no three-type.After ?2 test,the difference was not statistically significant(?2 = 2.645,P = 0.457).3.2.7 Nerve invasion and PKM2 expression analysis: no nerve invasion:PKM2 positive expression of 42 cases(72.42%),negative expression in 8cases(13.79%);nerve invasion: PKM2 positive expression in 8 cases(13.79%),Negative expression of 0 cases(0.00%).After ?2 test,the difference was not statistically significant(?2 = 1.069,P = 0.586).3.3 Analysis of gender and PARP and PKM2 expression3.3.1 The expression of PKM2 in male breast cancer was significantly higher than that in female breast cancer(P <0.05).The expression of PKM2 in male breast cancer was significantly higher than that in female breast cancer(P <0.05)Negative expression in 17 cases(29.31%).The ?2test,the difference between the two groups was statistically significant(?2 = 4.130,P = 0.042).3.3.2 The expression of PARP in male breast cancer PARP was 51 cases(87.93%)and negative in 7 cases(12.07%).The positive expression ofPARP in female breast cancer was 16 cases(27.59%),Negative expression of 42 cases(72.41%).The ?2 test,the difference between the two groups was statistically significant(?2 = 4.393,P = 0.036).3.4 Correlation analysis of PARP1 and PKM2 expression in MBC:By Spearman rank correlation test,there was a positive correlation between them(r=0.303,P=0.021).4 Kaplan-Meier Univariate Analysis of OS and Clinical Indicators in MBC4.1 Age and OS:?44 years old patients,OS for 4 to 101 months,median18.5 months;45 to 59 years old patients,OS for 6 to 128 months,the median 40 months;? 60 age group,OS For 2 to 105 months,median34.5 months.There was no significant difference between the three groups(?2 = 2.498,P = 0.287)by log-rank test.4.2 Vascular thrombosis and OS: no vascular tumor thrombus: OS for 2 to125 months,the median 35 months;with vascular thrombosis: OS for 4 to128 months,the median 34 months.There was significant difference between the two groups(?2 =4.127,P =0.042)by log-rank test.4.3 Lymph node metastasis and OS: no lymph node metastasis: OS for 2to 128 months,median 44.5 months;lymph node metastasis 1-3: OS for 4to 125 months,median 19 months;lymph node metastasis 4-9: OS 27 to70 months,median 45 months;lymph node metastasis ? 10: OS for 14 to34 months,median 25.5 months.There was significant difference between the two groups(?2 = 4.588 P = 0.032)by log-rank test.4.4 OS and histological grade:grade I: OS was 23 to 95 months,median32 months;grade II: OS was 2 to 128 months,median 36 months;grade III: OS: 4 ~ 125 Month,median 34.5 months.There was no significant difference between the three groups(?2 = 0.208,P = 0.901)by log-rank test.4.5 OS and tumor diameter:tumor diameter?2cm,OS for 2 ~ 128 months,the median 34 months;tumor diameter> 2cm,? 5cm: OS for 4 to 88 months,the median 33 months;tumor diameter > 5cm: OS is 43 ~ 95 months,median 69 months.There was no significant difference between the three groups(?2 = 0.108,P = 0.948)by log-rank test.4.6 TNM staging and OS: stage I: OS for 2 to 128 months,median 55months;stage ?: OS for 4 to 125 months,median 35 months;stage III:OS for 13 to 70 months,Median 32.5 months.There was significant difference between the three groups(?2 = 6.039,P = 0.049)by log-rank test.4.6 Molecular typing and OS: Luminal B: OS 4 to 128 months,median34 months;non-Luminal B type: OS for 2 to 93 months,median 44 months.There was no significant difference between the two groups(?2= 0.087,P = 0.958)by log-rank test.4.8 nerve invasion and OS: no nerve invasion: OS for 4 to 125 months,the median 34.5 months;nerve invasion: OS for 2 to 128 months,median44.5 months.There was no significant difference between the two groups(?2 = 0.399,P = 0.528)by log-rank test.4.9 OS and vascular invasion,lymph node metastasis and TNM staging of multi factor expression analysis: analysis by multiple factor Cox,vascular invasion,lymph node metastasis and TNM stage were independent factors affecting the prognosis of male breast cancer(P<0.05).5 Expression of OS and PARP1 and PKM2 in MBC5.1 OS and PARP1 expression analysis: PARP1 positive expression: OS for 2 to 128 months,the median 34 months;PARP1 negative expression:OS for 18 to 125 months,median 53 months.The difference was statistically significant(?2 = 4.715,P = 0.030)by log-rank test.5.2 OS and PKM2 expression analysis: PKM2 positive expression: OS for 2 to 125 months,median 32.5 months;PKM2 negative expression:OS for 28 to 125 months,the median 81.5 months.The difference was statistically significant(?2 = 4.136,P = 0.042)by log-rank test.5.3 OS and PARP1,PKM2 multivariate expression analysis: Multivariate analysis of Cox,PARP1,PKM2 is not an independent factor affecting theprognosis of male breast cancer.Conclusion:1 The clinicopathological features of PARP1,PKM2,such as vascular tumor embolus,lymph node metastasis and TNM stage are not the factors influencing the expression of male breast cancer.2 The expression of PARP1 and PKM2 in male breast cancer was positively correlated.3 Sex is the influence factors of the PARP1 and PKM2 expression in breast cancer4 Tubule thrombus,lymph node metastasis and TNM staging are the influencing factors of prognosis and survival time of male breast cancer,and it is an independent influencing factor of prognosis and survival time.5 The expression of PARP1 and PKM2 in male breast cancer was associated with prognosis,but neither was the independent prognostic factor. |
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