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目的通过检测乳腺癌标本中胸苷酸合成酶(TS)、胸腺嘧啶脱氧核苷磷酸化酶(TP)、二氟嘧啶脱氢酶(DPD)表达情况,探讨乳腺癌的生物学行为与上述3个指标之间的相关性。方法采用免疫组织化学(ABC法)检测228例乳腺癌组织中TS、TP和DPD的表达情况。结果TS、TP与患者的肿瘤大小、淋巴结状态、组织学分级及MVC有明显的相关性,与患者的年龄、激素受体状态(ER,PR)无关;DPD的表达与患者的年龄,肿瘤大小,淋巴结状态,激素受体状态(ER,PR)、组织学分级及MVC等诸多临床病理因素均无相关性;TS、TP表达阳性患者的10年无病生存率和总生存率明显低于表达阴性者(0、0、3·9%、0·9%和25%、25·4%、58·8%、61·8%),具有显著的统计学差异(均P<0·01);DPD表达阳性和阴性患者的10年无病生存率和总生存率为8·8%、16·2%、23·3%、39·5%,均无显著性差异(均P>0·05)。多因素分析发现:组织学分级、淋巴结状态、TS和TP的表达与患者的总生存率都有十分明显的相关性,而且TS和TP的危险系数分别为0·379、0·219,均小于1,这同样说明这两者对于总生存率来说都是非常强烈的保护因素。结论TS、TP表达水平的高低有可能是乳腺癌患者一个重要的预后指标;DPD的表达与临床病理因素、10年无病生存和总生存率之间无任何相关性。
Objective To investigate the expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and difluoropyrimidine dehydrogenase (DPD) in breast cancer specimens and to explore the biological behavior of breast cancer. The correlation between the indicators. Methods Immunohistochemistry (ABC method) was used to detect the expression of TS, TP and DPD in 228 cases of breast cancer. Results TS, TP had a significant correlation with tumor size, lymph node status, histological grade, and MVC. It was not related to age, hormone receptor status (ER, PR); DPD expression was related to patient’s age, tumor size. There was no correlation between lymph node status, hormone receptor status (ER, PR), histological grade and MVC, and other clinicopathological factors; 10-year disease-free and overall survival rates of TS, TP positive patients were significantly lower than expression. Negatives (0, 0, 3.9%, 0.9%, 25%, 25.4%, 58.8%, 61.8%) were statistically significant (all P<0.01). The 10-year disease-free survival rate and overall survival rate of patients with positive and negative DPD expression were 8.8%, 16.2%, 23.3%, and 39.5%, and there were no significant differences (all P>0. 05). Multivariate analysis showed that the histological grade, lymph node status, expression of TS and TP were significantly correlated with the overall survival rate of the patients, and the risk factors for TS and TP were 0·379 and 0·219, respectively. 1, which also shows that both are very strong protection factors for the overall survival rate. Conclusion The expression level of TS and TP may be an important prognostic indicator for breast cancer patients; there is no correlation between the expression of DPD and clinical pathological factors, 10-year disease-free survival and overall survival.