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目的探讨Wnt-1诱导分泌蛋白-1(WISP-1)表达与乳腺癌预后的关系。方法本研究选取南昌市第三医院2011年1~6月手术切除且经常规病理证实的浸润性乳腺癌标本120例及其癌旁组织进行回顾性分析。采用免疫组织化学EnVision两步法检测WISP-1蛋白在120例乳腺癌组织及其癌旁组织中的表达,同时收集这些患者的临床特征以及随访结果,采用χ~2检验分析乳腺癌组织中WISP-1表达与患者临床病理特征的关系,采用Kaplan-Meier法计算患者生存率,采用Log-rank检验比较患者生存差异,并用Cox比例风险模型分析影响乳腺癌患者预后的因素。结果 WISP-1在浸润性乳腺癌中的阳性表达率(85%,102/120)明显高于癌旁组织(35%,42/120)(χ~2=7.653,P=0.003)。WISP-1表达与患者的肿瘤组织学分级(χ~2=22.846,P<0.001)、淋巴结转移(χ~2=11.663,P=0.001)、HER-2表达(χ~2=7.825,P=0.005)以及远处转移(χ~2=35.737,P<0.001)有关。患者随访时间为24.0~60.0个月,中位随访时间为43.9个月。生存分析结果发现,WISP-1表达水平是患者DFS的预后因素(χ~2=19.354,P<0.001)。低表达WISP-1的患者出现复发转移的中位时间是48个月,而高表达WISP-1的患者出现复发转移的中位时间是40个月。Cox比例风险模型分析提示,WISP-1(OR=2.129,95%CI:1.099~4.124,P=0.025)、年龄(OR=4.617,95%CI:2.803~7.605,P<0.001)、淋巴结转移(OR=2.014,95%CI:1.209~3.355,P=0.007)是乳腺癌患者DFS的独立预后因素。结论高表达WISP-1的乳腺癌患者预后更差,WISP-1蛋白可能是乳腺癌预后的标志物。
Objective To investigate the relationship between Wnt-1-induced secretory protein-1 (WISP-1) expression and the prognosis of breast cancer. Methods In this study, 120 cases of invasive breast cancer specimens and their peritumoral tissues surgically removed from the Third Hospital of Nanchang from January 2011 to June 2011 were retrospectively analyzed. Immunohistochemistry EnVision two-step method was used to detect the expression of WISP-1 protein in 120 cases of breast cancer tissues and their adjacent tissues. Meanwhile, the clinical features and follow-up results of these patients were collected. The WISP -1 expression and clinicopathological features of patients with Kaplan-Meier method to calculate the survival rate of patients, the survival of patients by Log-rank test, and Cox proportional hazards model to analyze the prognosis of breast cancer patients. Results The positive expression rate of WISP-1 in invasive breast cancer (85%, 102/120) was significantly higher than that in paracancerous tissues (35%, 42/120) (χ ~ 2 = 7.653, P = 0.003). The expression of WISP-1 was significantly correlated with the tumor histological grade (χ ~ 2 = 22.846, P <0.001), lymph node metastasis (χ ~ 2 = 11.663, P = 0.001) 0.005) and distant metastasis (χ ~ 2 = 35.737, P <0.001). Patients were followed up for 24.0-60.0 months with a median follow-up of 43.9 months. Survival analysis revealed that WISP-1 expression was a prognostic factor for DFS (χ ~ 2 = 19.354, P <0.001). The median time to recurrence and metastasis in patients with low expression of WISP-1 was 48 months, while the median time to recurrence and metastasis in patients with high expression of WISP-1 was 40 months. Cox proportional hazards model analysis showed that WISP-1 (OR = 2.129,95% CI: 1.099-4.124, P = 0.025), age (OR = 4.617,95% CI: 2.803-7.605, P <0.001), lymph node metastasis OR = 2.014, 95% CI: 1.209-3.355, P = 0.007) were independent predictors of DFS in breast cancer patients. Conclusion The prognosis of breast cancer patients with WISP-1 overexpression is even worse. WISP-1 protein may be a marker of breast cancer prognosis.