2018 年第 9 期 第 13 卷

三阴与非三阴性乳腺癌患者肿瘤标志物及Ki-67的表达

Expressions of tumor markers and Ki-67 in triple-negative and non-triple-negative breast cancer

作者：邢芳林许瑞张璐璐焦伟段文冰李晓莹赵万辉

英文作者：

单位：250021济南，山东大学附属省立医院临床医学检验部（邢芳林、许瑞、张璐璐、段文冰、李晓莹、赵万辉）；276800山东省日照市妇幼保健院检验科（焦伟）

英文单位：

关键词：三阴性乳腺癌；癌胚抗原；糖类抗原125；糖类抗原153；Ki-67

英文关键词：

• 摘要：

• 【摘要】目的    探讨三阴性乳腺癌（TNBC）与非TNBC患者肿瘤标志物及Ki-67的表达。方法    选择2016年8月至2017年5月山东大学附属省立医院经病理检查确诊的女性乳腺癌患者184例，其中TNBC组32例，非TNBC组152例，另选择同期收治女性乳腺良性肿瘤疾病患者41例（乳腺良性肿瘤组），采用化学发光法检测3组患者肿瘤标志物癌胚抗原、糖类抗原125、糖类抗原153，采用免疫组织化学法检测2组乳腺癌患者手术切除病理组织Ki-67的表达，比较2组乳腺癌患者临床病理特征及与Ki-67阳性指数的关系。结果    TNBC组糖类抗原125、糖类抗原153水平高于非TNBC组和乳腺良性肿瘤组，且非TNBC组高于乳腺良性肿瘤组，差异均有统计学意义（均P<0.05）；TNBC组、非TNBC组癌胚抗原表达水平高于乳腺良性肿瘤组，差异均有统计学意义（均P<0.05），但TNBC组与非TNBC组比较差异无统计学意义（P>0.05）。TNBC组肿瘤长径≤2 cm 7例、>2 cm 25例，有淋巴结转移22例（68.8%）；非TNBC组肿瘤长径≤2 cm 66例、>2 cm 86例，有淋巴结转移72例（47.4%）。2组患者间肿瘤长径和淋巴结转移率比较差异均有统计学意义（均P<0.05），年龄和组织学分级比较差异均无统计学意义（均P>0.05）。TNBC组Ki-67阳性指数明显高于非TNBC组［40%(20%,42%)比20%(15%,30%)］，差异有统计学意义（P<0.05）。2组不同年龄、肿瘤长径、淋巴结转移情况和组织学分级乳腺癌患者的Ki-67阳性指数比较差异均无统计学意义（均P>0.05）。结论    TNBC患者Ki-67阳性指数较高，淋巴结转移比例和肿瘤长径>2 cm比例较高，同时癌胚抗原、糖类抗原125、糖类抗原153也是TNBC治疗及预后判断的重要辅助诊断指标。

• 【Abstract】Objective    To investigate the expressions of tumor markers and Ki-67 in triple-negative breast cancer（TNBC） and non-TNBC. Methods    From August 2016 to May 2017, clinical records of 184 patients with breast cancer(32 TNBC and 152 non-TNBC) and 41 patients with benign breast disease in Shandong Provincial Hospital Affiliated to Shandong University were collected. Carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125) and CA153 were detected by chemiluminescence. Ki-67 was detected by immunohistochemistry. The relation between clinicopathological features of breast cancer and Ki-67 expression was analyzed. Results    Levels of CA125 and CA153 in TNBC were significantly higher than those in non-TNBC and benign breast disease(P<0.05). CEA level in TNBC and non-TNBC was significantly higher than that in benign breast disease(P<0.05), but there was no significant difference between TNBC and non-TNBC（P>0.05）. In TNBC, tumor diameter was ≤2 cm in 7 cases and >2 cm in 25 cases; 22 patients（68.8%） had lymphatic metastasis. In non-TNBC, there were 66 cases of tumor diameter≤2 cm and 86 cases of tumor diameter>2 cm; 72 patients（47.4%） had lymphatic metastasis. Tumor diameter, lymphatic metastasis, age and histological grade showed no significant difference between TNBC and non-TNBC(P>0.05). Expression of Ki-67 in TNBC was higher than that in non-TNBC［40%(20%,42%)vs 20%(15%,30%)］（P<0.05）. Expression of Ki-67 showed no significant difference among breast cancer patients with different age, tumor diameter, lymphatic metastasis and histological grade(P<0.05). Conclusion    TNBC patients have high expression of Ki-67, high rate of lymph node metastasis and large tumor size; CEA, CA153 and CA125 are important diagnostic indicators of TNBC.