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目的探讨乳腺癌细胞增殖活性、bcl2和突变型p53蛋白表达水平的临床意义。方法应用流式细胞术检测121例乳腺癌的DNA倍体、S期细胞百分比(SPF)及bcl2和突变型p53表达阳性率,结合雌激素受体测定和66例乳腺浸润性导管癌的组织学分级进行统计学分析。结果66例乳腺浸润性导管癌组织Ⅰ、Ⅱ、Ⅲ级间异倍体阳性率、DNA指数(DI)差异均有统计学意义(P均<0.01)。乳腺癌组织Ⅰ、Ⅱ、Ⅲ级的SPF分别为(1.84±1.02)%、(2.44±1.07)%和(2.71±1.16)%,差异有统计学意义(P<0.05);突变型p53表达阳性率分别为(1.03±1.11)%、(2.91±1.61)%和(3.37±2.13)%,差异有统计学意义(P<0.05);bcl2阳性表达率差异无统计学意义(P>0.05),但癌组织与正常组织间差异有统计学意义。雌激素受体阳性与阴性两组间,SPF分别为(2.17±1.04)%和(4.56±1.77)%,突变型p53蛋白表达阳性率分别为(2.93±1.63)%和(4.39±2.73)%,差异均有统计学意义(P<0.05),而bcl2表达阳性率差异无统计学意义(P>0.05)。DI、SPF和p53表达阳性率两两相关,DI与SPF、DI与p53表达阳性率、SPF与p53表达阳性率的相关系数分别为0.73,0.40和0.42(P均<0.01);bcl2表达阳性率与各指标之间无相关关系。结论突变型p53和bcl2与乳腺癌的发生有一定关系;异倍体率、DI与突变型p53表达阳性率可以提示肿瘤预后;流式细胞术检测可以作为病理诊断的补充;乳腺癌患者可术前通过流式细胞术检测提示预后,确立治疗模式。
Objective To investigate the clinical significance of breast cancer cell proliferation, bcl2 and mutant p53 protein expression. Methods The DNA ploidy, percentage of S phase cells (SPF) and the positive rates of bcl2 and mutant p53 in 121 cases of breast cancer were detected by flow cytometry. Combined with estrogen receptor assay and histological score of 66 cases of breast invasive ductal carcinoma Level for statistical analysis. Results There were significant differences in the aneuploidy rate and DNA index (DI) between 66 cases of invasive ductal carcinoma of the breast in grade Ⅰ, Ⅱ and Ⅲ (all P <0.01). (1.84 ± 1.02)%, (2.44 ± 1.07)% and (2.71 ± 1.16)% in breast cancer Ⅰ, Ⅱ and Ⅲ respectively, the difference was statistically significant (P <0.05); the positive expression of mutant p53 (1.03 ± 1.11)%, (2.91 ± 1.61)% and (3.37 ± 2.13)%, respectively, the difference was statistically significant (P <0.05). There was no significant difference in the expression of bcl2 between the two groups (P> 0.05) However, the difference between cancer and normal tissues was statistically significant. The positive rates of SPF were (2.17 ± 1.04)% and (4.56 ± 1.77)% in estrogen receptor positive and negative groups respectively, and the positive rates of mutant p53 protein were (2.93 ± 1.63)% and (4.39 ± 2.73)%, respectively , The differences were statistically significant (P <0.05), while the positive rate of bcl2 expression was no significant difference (P> 0.05). The positive rates of DI, SP, SP and p53 were DI, SPF, DI and p53, and the positive rates of SPF and p53 were 0.73,0.40 and 0.42 respectively (all P <0.01). The positive rate of bcl2 And no correlation between the indicators. Conclusions Mutant p53 and bcl2 are correlated with the occurrence of breast cancer. The positive rates of aneuploidy, DI and mutant p53 may indicate the prognosis of the tumor. Flow cytometry can be used as a complement to pathological diagnosis. Pre-flow cytometry prompted the prognosis, the establishment of treatment patterns.