三阴性乳腺癌中MMP9和P53的表达与其预后的关系研究

目的:研究三阴性乳腺癌(triple negative breast cancer,TNBC)中基质金属蛋白酶9(matrix metal proteinase 9,MMP9)和P53的表达及其与三阴性乳腺癌预后的关系。方法:收集2002年3月至2011年7月上海交通大学医学院附属新华医院普外科诊治且临床资料完整的TNBC标本147例,通过免疫组化检测其MMP9、P53的表达。结合临床随访数据,分析MMP9、P53的表达与TNBC预后的关系。结果:TNBC占同期本院收治的乳腺癌13.3%(147/1103)。MMP9、P53在TNBC中的阳性表达率分别为47.6%和66.0%。MMP9与TNBC患者的淋巴结转移数显著相关(P=0.003)。MMP9表达阳性的TNBC与MMP9表达阴性TNBC患者60个月的无病生存(disease free survival,DFS)率分别为62%和83%,差异具有统计学意义(P=0.001);总体生存率(overall survival,OS)率分别为66%和73%,差异具有统计学意义(P=0.022)。P53表达阳性的TNBC和P53表达阴性的TNBC患者60个月的DFS分别为65%和87%(P=0.010);OS分别为60%和85%(P=0.005)。MMP9和P53的HR分别为3.353(95%CI:1.614-6.966,P=0.001)和2.979(95%CI:1.239-7.165,P=0.015)。结论:MMP9和P53在TNBC中的阳性表达与患者的预后不良有关,且MMP9为影响TNBC患者预后的独立危险因素。

Research on the Correlation of MMP9 and P53 Expression with the Prognosis of Triple Negative Breast Cancer*

Objective： To investigate the expression of MMP9 （matrix metal proteinase 9, MMP9） and P53 in TNBC （triple negative breast cancer, TNBC） ,and their relationship with the prognosis of TNBC. Methods： 147 cases of TNBC Paraffin specimens with complete clinical data which were treated in General Surgery Department, Affiliated Xinhua Hospital of Shanghai Jiaotong from March 2002 to July 2011 were collected. Expression of MMP9 and P53 were detected by immunohistochemistry. Combined with clinical follow-up data, the relationship between expression of MMP9/P53 and TNBC prognosis was studied. Results： In 1103 cases of breast cancer, 147 cases were TNBC （13.3%）. The positive expression rate of MMP9 and P53 in TNBC were 47.6% and 66.0% respectively. MMP9 expression was associated with the number ofmetastasizing lymph nodes （P=0.003）. The 60 months DFS （disease free survival rate） of TNBC patients with positive and negative MMP9 expression were 62% and 83% respectively,（P=0.001） and OS （Overall survival rate） were 66% and 73%（P=0.022）. The 60 months DFS of TNBC patients with positive and negative P53 expression were 65% and 87% respectively （P=0.010）, and OS were 60% and 85%（P=0.005）. The hazard ratio of metastasis or recurrence for the status of MMP9 and P53 were 3.353 （95%CI： 1.614-6.966, P=0.001） and 2.979 （95%CI：1.239-7.165,P=0.015） respectively. Conclusion： The upregulation of MMP9 and P53 expression were associated with the poor prognosis of patients with TNBC, and MMP9 was an independent risk factor. high expression of MMP9 and P53 indicated poor prognosis in TNBC.