P-gp、MMP-2、C-erbB-2在乳腺癌原发灶和转移淋巴结中的表达对比研究

目的：探讨乳腺癌侵袭转移和多药耐药之间的关系,为治疗方案的个体化提供依据。方法：采用免疫组化方法检测46例乳腺浸润性导管癌患者乳腺原发灶及相应腋淋巴结转移灶中P-gp、MMP-2、c-erbB-2的表达,结合临床表现、病理学指标,分析其相关性。结果：46例原发灶P-gp阳性表达35例（76.1%）,MMP-2阳性表达25例（54.3%）,c-erbB-2高表达18例（39.1%）;相应腋淋巴结转移灶P-gp阳性表达28例（60.9%）,MMP-2阳性表达16例（34.8%）,c-erbB-2高表达16例（34.8%）;P-gp、MMP-2蛋白表达水平与肿块大小、淋巴结转移数目均呈正相关（P〈0.05）,c-erbB-2蛋白表达水平与腋窝淋巴结转移数量呈正相关,与ER、PR表达呈负相关,P-gp阳性表达与MMP-2和c-erbB-2的表达呈正相关（P〈0.05）。结论：肿瘤原发灶与转移灶存在异质性,P-gp、MMP-2、c-erbB-2的表达与乳腺癌的多药耐药和侵袭转移有关,检测上述基因在原发灶与转移灶的表达,为乳腺癌选择个体化的化疗、内分泌治疗及分子靶向治疗提供了分子生物学依据。     

乳腺浸润性导管癌中PTTG与MMP-2和MMP-9 的表达及相关性

垂体瘤转化基因（PTTG）具有促进体外细胞转化和体内致瘤的能力,在乳腺癌组织中高表达,并与乳腺癌的复发和淋巴结转移有关.但PTTG 能否通过调节基质金属蛋白酶(MMP-2、MMP-9) 调控乳腺癌的侵袭与转移尚不清楚.本研究证明,PTTG可能因促进乳腺癌细胞中 MMP-2、MMP-9 分泌而在乳腺癌细胞侵袭、转移中发挥重要作用.免疫组织化学 PV 9000 通用型两步法显示,60例乳腺浸润性导管癌组织中,PTTG、MMP-2 和 MMP-9表达定位于肿瘤细胞胞浆,阳性率与周围正常乳腺组织相比,差异均具有统计学意义(P＜0.05).三者阳性表达均与淋巴结转移及TNM分期有关(P＜0.05);与患者年龄、肿瘤大小等无关(P＞0.05).乳腺浸润性导管癌中PTTG分别与MMP-2、MMP-9的表达呈正相关(P＜0.05).小RNA干扰技术干扰乳腺癌细胞株 MDA-MB-231 中的PTTG,Western印迹结果显示,干扰组与对照组相比,PTTG、MMP-2 和 MMP-9蛋白的表达水平明显下降. Transwell 侵袭实验显示,干扰组肿瘤细胞体外侵袭能力明显降低(P＜0.01).本研究表明,PTTG可能通过促进乳腺癌细胞中 MMP-2、MMP-9分泌,促进乳腺癌细胞的侵袭、转移.     

乳腺癌肺耐药蛋白表达及其与C-erbB-2和p53表达的关系

目的　探讨LRP在乳腺癌组织中的表达及其与C erbB 2和 p5 3表达的相关性。方法　采用免疫组化LSAB法检测 15 2例乳腺癌组织和 40例正常乳腺组织的LRP、C erbB 2和 p5 3蛋白的表达水平 ,并将结果与临床病理因素和预后资料进行分析。结果　在 15 2例乳腺癌组织中LRP、C erbB 2和 p5 3阳性例数分别为 12 2 ( 80 2 % )、 10 2 ( 67 1% )和 69( 45 4% ) ,乳腺对照组织LRP阳性 2 2例 ( 5 5 0 % ) ;乳腺癌组织LRP的表达明显高于对照组 ( χ2 =10 70 9,P <0 0 1) ,并与C erbB 2 ( χ2 =12 44 0 ,P <0 0 1,γ =0 2 9)和 p5 3 ( χ2 =8 5 0 0 ,P <0 0 1,γ =0 2 5 )表达呈正相关 ;在淋巴结转移组LRP阳性 62例 ( 88 6% ) ,无转移组阳性 60例 ( 73 2 % ) ,LRP的表达与淋巴结转移 ( χ2 =5 65 4,P <0 0 5 ,γ =0 19)呈正相关。单因素预后分析显示LRP阳性组生存期明显低于阴性组 ( χ2 =7 0 92 ,P <0 0 1)。结论　C erbB 2和p5 3可能诱导LRP表达上调 ,LRP表达可能与腋淋巴结转移、缩短常规化疗乳腺癌患者生存期有关     

EZH2在乳腺癌中的表达及其临床意义

目的 探讨EZH2在乳腺癌中的表达及其临床意义.方法 用免疫组化的方法研究105例乳腺癌中EZH2蛋白表达情况,并进一步探讨其与乳腺癌临床病理因素及其预后的关系.结果 EZH2蛋白在乳腺癌组织中表达明显高于乳腺良性疾病,其表达与患者年龄、肿瘤大小、TNM分期、PR和c-erbB-2表达无关(P＞0.05),与淋巴结转移、病理组织学分级、ER表达及乳腺癌预后相关(P＜0.05).EZH2蛋白表达在三阴性乳腺癌中表达明显高于非三阴性乳腺癌(P＜0.05).结论 EZH2在乳腺癌淋巴结转移及侵袭中扮演一定的角色,其与乳腺癌预后相关,与ER阴性的乳腺癌发生发展有关.     

PI3K/AKT 通路参与调控乳腺癌多药耐药和侵袭转移的研究

目的:探讨磷脂酰肌醇-3-激酶/丝苏氨酸蛋白激酶(phosphatidylinositol 3 kinase/serine-threonine kinase,PI3K/AKT)信号通路与乳腺癌多药耐药和侵袭转移的相关性。方法:以乳腺癌细胞系MCF-7为母本,持续低浓度加药诱导建立阿霉素(Adriamycin,ADR)耐药系MCF-7/ADR’。细胞免疫荧光检测两细胞系中磷酸化AKT(phosphorylated AKT,P-AKT)、P-糖蛋白(P-Glycoprotein,P-gp)、基质金属蛋白酶2(matrix metalloproteinase-2,MMP-2)的表达。PI3K抑制剂LY294002作用两系前后,Western Blot检测P-AKT、MMP-2、P-gp的表达改变及qRT-PCR检测MMP-2、MDR1的表达改变。结果:P-AKT、P-gp(MDR1)、MMP-2在MCF-7中为低表达或不表达,MCF-7/ADR’中为高表达。LY294002作用两系后,P-AKT、P-gp(MDR1)、MMP-2在MCF-7/ADR’中的表达明显减低(P<0.05),MCF-7无明显改变。结论:抑制PI3K/AKT信号通路可有效降低MCF-7/ADR’耐药和侵袭转移能力,PI3K/AKT通路是调控乳腺癌多药耐药和侵袭转移的重要信号通路之一。     

PTEN及COX-2在乳腺癌的表达、意义及相关性

目的:研究PTEN及COX-2在乳腺癌的表达、与临床病理特征的关系及二者表达的相关性.方法:采用免疫组化技术(S-P法)检测48例乳腺癌和12例乳腺纤维腺瘤中PTEN、COX-2的表达情况.结果:PTEN在乳腺癌中的高表达率52.08%(25/48)明显低于乳腺纤维腺瘤91.67%(11/12)(p<0.05);PTEN的表达水平与腋淋巴结转移呈负相关,与ER水平呈正相关.与乳腺纤维腺瘤组织16.67%(2/12)相比,COX-2在乳腺癌组织中的表达明显增强68.75%(33/48)(P<0.05),COX-2与肿瘤大小、临床分期、淋巴结转移及ER、PR水平有关.结论:PTEN和COX-2的异常表达与乳腺癌发生、发展密切相关;PTEN和COX-2在乳腺癌中的表达呈负相关,两者共同参与了乳腺癌发生和发展.     

Kiss-1、MMP2、TIMP2蛋白在甲状腺乳头状癌中的表达及临床意义

目的探讨Kiss-1、基质金属蛋白酶-2(MMP2),组织金属蛋白酶抑制剂-2(TIMP2)在甲状腺乳头状癌(PTC)原发灶与淋巴结转移灶中的表达。方法采用免疫组织化学方法检测86例PTC原发灶及其40例颈部淋巴结转移性癌灶中Kiss-1、MMP2、TIMP2的表达。结果 1.伴有颈部淋巴结转移的PTC原发灶中MMP2的表达强度高于无淋巴结转移者,而前者Kiss-1、TIMP2的表达强度均低于后者,两者的差异均具有统计学意义(P0.05);2.PTC转移灶中MMP2的表达强度高于原发灶,它们的差异均具有统计学意义(P0.05),而TIMP2、Kiss-1在原发灶与转移灶中表达强度的差异无具统计学意义(P0.05);3.三者在PTC原发灶和转移灶中表达强度的自身对比差异均具有统计学意义(P0.05);4.在PTC有转移组原发灶中,Kiss-1的表达与MMP2、TIMP2的表达相关(r=0.604,P0.05;r=0.819,P0.05);在PTC无转移组原发灶中,Kiss-1的表达与MMP2、TIMP2的表达相关(r=0.906,P0.05;r=0.915,P0.05)。结论 MMP2在PTC癌组织中的表达增强,尤其在转移灶中的高表达可能在PTC淋巴结转移过程中起着主导作用;而TIMP2、Kiss-1的表达下调,尤其在自身转移灶中的低表达可能在转移过程中与前者相得益彰。     

基因MMP-2、PTEN和Fn的表达与胃癌临床病理因素的关系

为了探讨基因MMP-2、PTEN和FN与胃癌临床病理因素的关系,采用免疫组织化学方法,检测了56例胃癌中MMP-2、PTEN和Fn的表达.结果表明:MMP-2、PTEN的阳性表达和Fn的异常表达分别为58.9%、55.4%和60.7%.低分化癌中MMP-2的表达和Fn的异常高于高分化癌(P<0.05).MMP-2的表达和Fn的异常与胃癌浸润深度、淋巴结转移正相关(P<0.05),PTEN的表达与淋巴结转移负相反(P<0.05).MMP-2和PTEN的表达呈负相关(P<0.05),MMP-2表达和Fn的异常呈正相关(P<0.01),PTEN表达与Fn异常之间无明显相关性(P>0.5).通过该研究发现,检测胃癌组织中MMP-2、PTEN和Fn的表达,有助于了解胃癌的发展和评估胃癌患者的预后.     

MMP-2、Galectin-3、Cx43与胃癌侵袭和转移的关系

目的:通过检测胃癌组织和癌旁组织中MMP-2、Galectin-3、Cx43的表达情况,研究它们与胃癌发生、发展、侵袭及转移的关系。方法:应用免疫组织化学(SP法)法检测MMP-2、Galectin-3、Cx43在胃癌组织和癌旁组织中的表达情况。结果:MMP-2、Galectin-3在胃癌组织中的阳性表达均明显高于胃癌癌旁组织(P0.05),并且均与浸润深度、淋巴结转移情况和临床分期明显相关(P0.05);MMP-2与胃癌的分化程度有关,而Galectin-3与胃癌的分化程度无关;Cx43在20例胃癌癌旁组织中的阳性表达率达100%,在胃癌组织中阳性表达率为39.7%,在癌旁组织中的阳性表达明显高于胃癌组织,具有统计学意义(P0.05),Cx43的表达在胃癌的分化程度、浸润深度、淋巴结转移情况及临床分期方面存在显著差异,具有统计学意义(P0.05);MMP-2阳性表达与Cx43阳性表达呈负相关(P=0.02,r=-0.292),而与Galectin-3阳性表达均为正相关(P=0.003,r=0.344)。结论:在胃癌的发生、发展过程中Galectin-3与MMP-2有促进作用,而Cx43有抑制作用,三者在胃癌的侵袭和转移中均发挥重要作用。     

PTEN蛋白表达和明胶酶及其抑制因子在乳腺癌侵袭转移中的关系

目的研究乳腺癌中明胶酶(MMP-2、MMP-9)及其抑制物(TIMP-1)与抑癌基因PTEN产物PTEN蛋白的表达在肿瘤侵袭转移中的关系.方法应用免疫组织化学S-P法检测98例浸润性乳腺癌组织MMP-2、MMP-9及TIMP-1和PTEN蛋白的表达.结果乳腺癌MMP-2、MMP-9与PTEN表达呈显著负相关,而TIMP-1与PTEN蛋白表达呈显著正相关(P<0.05).在PTEN低表达组中,MMP-2、MMP-9的表达与腋窝淋巴结受累呈正相关;在PTEN高表达组中,MMP-2、MMP-9的表达与腋窝淋巴结受累呈正相关,TIMP-1与腋窝淋巴结受累呈负相关.结论在乳腺癌侵袭转移中MMP-2、MMP-9、TIMP-1与PTEN蛋白表达显著相关.MMP-2、MMP-9和TIMP-1对肿瘤细胞侵袭转移的作用可能在一定程度上受到PTEN的调控.     

胃癌原发灶及淋巴结Her2 基因表达的差异性研究

目的:明确胃癌原发灶与其转移淋巴结中Her2过表达或扩增的差异性,为临床胃癌治疗方案的选择提供参考依据。方法:选择112例经术后病理检查证实为胃癌原发灶Her2强阳性(Her2阳性表达为3+)表达并伴有淋巴结转移的患者样本,应用免疫组化方法并参照《胃癌Her2检测指南》中规定的检测流程重新判定有Her2过表达或扩增的胃癌原发病灶其相应的转移淋巴结中Her2有无过表达或扩增,再将检测结果进行比较。结果:112例患者中,胃癌组织Her2的阳性率为74.11%,淋巴结Her2的阳性表达为66.07%,二者共同阳性表达率为61.61%,差异无统计学意义(P=0.064)。两,二者一致率为83.04%,kappa检验结果为(Z=6.452,P0.001)。胃癌组织Her2的基因表达与年龄、性别、肿瘤位置和肿瘤大小以及远端转移均无显著相关性,而与Lauren分型、组织学分级、浸润深度、淋巴结转移以及TNM分期有关(P0.05)。结论:胃癌原发病灶中Her2过表达或扩增与其相应的转移淋巴结中Her2过表达或扩增具有一致性。胃癌组织Her2状态与Lauren分型、组织学分级、浸润深度、淋巴结转移以及TNM分期有关。     

HER-2/neu gene in primary and local metastatic axillary lymph nodes in human breast tumors.

In order to verify whether the HER-2/neu gene is involved in the initial phases of neoplastic disease or in its progression, we evaluated the amplification and overexpression of this gene in the primary tumor and in synchronous metastatic axillary lymph nodes of 26 women with operable breast cancer. HER-2/neu was amplified in 35% and overexpressed in 33% of the primary sites; similar percentages were found in lymph nodes. The clear correlation between the two disease sites regarding gene, mRNA and protein levels, supports the hypothesis that this gene is involved in the initial and invasive phases of neoplasia. Its actual role with respect to other biological tumor characteristics during the metastatic process should be investigated further.     

Analysis of c-erbB-2 protein expression in conjunction with DNA content using multiparameter flow cytometry

Breast cancer is a leading cause of cancer death among women. Factors useful for determining the prognosis of breast cancer include axillary lymph node involvement, tumor size, hormonal receptor status, nuclear grade, and relative DNA content. The c-erbB-2 protooncogene is amplified in 10-40% of primary breast tumors, as well as in breast cancer cell lines; where it is amplified there is increased expression of its product. We have investigated the DNA content and c-erbB-1 protein expression in tumor cell lines and in breast cancer patient specimens by multiparameter flow cytometry. The study was enabled by the discovery that both cellular integrity and c-erbB-2 antigen reactivity were preserved in cells and tissues following fixation in 70% ethanol. We demonstrate that flow cytometric analysis of c-erbB-2 expression in populations of ethanol-fixed tumor cells is a reliable and sensitive quantitative method that correlates well with previously documented semiquantitative techniques. This is a feasible method for analyzing archived clinical samples, and further allows correlations between c-erbB-2 levels and other cellular parameters. Additionally, this method detects abnormal populations not identified by DNA content analysis alone. Further studies utilizing this approach are necessary to evaluate the prognostic value of this oncoprotein in human breast cancer.     

PRC2/EED-EZH2 Complex Is Up-Regulated in Breast Cancer Lymph Node Metastasis Compared to Primary Tumor and Correlates with Tumor Proliferation In Situ

Background

Lymph node metastasis is a key event in the progression of breast cancer. Therefore it is important to understand the underlying mechanisms which facilitate regional lymph node metastatic progression.

Methodology/Principal Findings

We performed gene expression profiling of purified tumor cells from human breast tumor and lymph node metastasis. By microarray network analysis, we found an increased expression of polycomb repression complex 2 (PRC2) core subunits EED and EZH2 in lymph node metastatic tumor cells over primary tumor cells which were validated through real-time PCR. Additionally, immunohistochemical (IHC) staining and quantitative image analysis of whole tissue sections showed a significant increase of EZH2 expressing tumor cells in lymph nodes over paired primary breast tumors, which strongly correlated with tumor cell proliferation in situ. We further explored the mechanisms of PRC2 gene up-regulation in metastatic tumor cells and found up-regulation of E2F genes, MYC targets and down-regulation of tumor suppressor gene E-cadherin targets in lymph node metastasis through GSEA analyses. Using IHC, the expression of potential EZH2 target, E-cadherin was examined in paired primary/lymph node samples and was found to be significantly decreased in lymph node metastases over paired primary tumors.

Conclusions/Significance

This study identified an over expression of the epigenetic silencing complex PRC2/EED-EZH2 in breast cancer lymph node metastasis as compared to primary tumor and its positive association with tumor cell proliferation in situ. Concurrently, PRC2 target protein E-cadherin was significant decreased in lymph node metastases, suggesting PRC2 promotes epithelial mesenchymal transition (EMT) in lymph node metastatic process through repression of E-cadherin. These results indicate that epigenetic regulation mediated by PRC2 proteins may provide additional advantage for the outgrowth of metastatic tumor cells in lymph nodes. This opens up epigenetic drug development possibilities for the treatment and prevention of lymph node metastasis in breast cancer.     

C-erBb-2、MMP-9 在结直肠癌中的表达及相关意义

目的:探讨C-erBb-2、基质金属蛋白酶-9(MMP-9)在结直肠癌中的表达与其浸润转移的关系,寻找浸润转移的客观指标及可能相关机制。方法:用免疫组化法测定80例结直肠癌组织中C-erBb-2和MMP-9的表达情况。结果:①C-erBb-2、MMP-9在结直肠癌组织中阳性表达率60.0%,(48/80)和56.2%(45/80)。②在有淋巴结转移的结直肠癌组织中C-erBb-2、MMP-9阳性率分别为75.0%(30/40)、72.5%(29/40),高于无淋巴结转移的结直肠癌组织中的C-erBb-2、MMP-9阳性率45%(18/30)、40.0%(16/40),(P<0.05);③二者共同阳性者淋巴结转移率为78.1%(25/32)高于二者均阴性者淋巴结转移率26.3%(5/19),(P<0.05),④C-erBb-2、MMP-9联合表达存在意义,且为正相关(r=0.257,P<0.05)。⑤C-erBb-2、MMP-9的表达与肿瘤的大小、性别、年龄、浸润层次等因素无关,但与肿瘤分期、淋巴结转移、分化有关。结论:C-erBb-2、MMP-9表达与淋巴结转移密切相关,二者在有淋巴结转移的结直肠癌组织中表达可能存在协同作用,可作为临床检测淋巴结转移的重要指标之一。     

CD147 depletion down-regulates matrix metalloproteinase-11, vascular endothelial growth factor-A expression and the lymphatic metastasis potential of murine hepatocarcinoma Hca-F cells

Extracellular matrix metalloproteinase inducer (EMMPRIN, CD147), which is a plasma membrane glycoprotein enriched on the surface of many malignant tumors promotes adhesion, invasion and metastasis of tumor cells. In addition, tumor-associated CD147 also induces vascular endothelial growth factors (VEGFs) expression. To investigate the possible role of CD147 in the mouse hepatocarcinoma cell line Hca-F with highly metastatic potential in the lymph nodes, we used an RNA interference (RNAi) approach to silence CD147 expression. The results showed that CD147 depletion in Hca-F cells resulted in the significantly decreased expression of matrix metalloproteinase-11 (MMP-11), VEGF-A at both mRNA and protein levels. The reduced CD147 expression also attenuated the invasive, adhesive, metastatic ability of Hca-F cells to lymph nodes both in vitro and in vivo. Our current findings reveal that the tumor biological marker CD147 functionally mediates MMP-11, VEGF-A expression and tumor lymphatic metastasis.     

Tumor metastasis in an orthotopic murine model of head and neck cancer: possible role of TGF-beta 1 secreted by the tumor cells

In an orthotopic murine model of head and neck cancer, combined subcutaneous and intratumoral vaccination with recombinant vaccinia virus expressing interleukin-2 (rvv-IL-2) induced significant tumor regression early on therapy. However, its efficacy was restricted by recurrent tumor growth and loco-regional metastases. In this study, we explored the mechanism of tumor metastasis. We compared the levels of expression of a number of molecules involved in tumor metastasis, which included transforming growth factor-beta1 (TGF-beta1), E-cadherin, matrix metalloproteinases (MMPs): MT1-MMP, MMP-2, MMP-9, their tissue inhibitors (TIMPs): TIMP-1/TIMP-2, and pro-angiogenic factors CD31, VEGF-R2, and iNOS between primary and metastatic tumors by real-time RT-PCR and immunohistochemistry. We detected spontaneous lymph node and tongue metastasis. Metastasis was delayed in rvv-IL-2 treated mice. Cultured tumor cells expressed negligible amount of TGF-beta1. Untreated or metastatic tumors, on the other hand, expressed high levels of TGF-beta1 and secreted TGF-beta1 in the sera of tumor-bearing mice. Levels of TGF-beta1 in the sera suddenly jumped at the time when tumor metastasis started. In the metastatic tumors, levels of MT1-MMP, MMP-2, and MMP-9 were significantly elevated (P < 0.001), while levels of TIMP-1/TIMP-2 and E-cadherin were decreased (P < 0.001) compared to control or primary tumors. Levels of CD31, VEGF-R2, and iNOS were also significantly elevated in the metastatic lesions (P < 0.001). The concurrence of high levels of TGF-beta1 in the sera, expression of proteins involved in metastasis and initiation of metastasis suggested possible role of TGF-beta1 in on setting the metastatic cascade in this model.     

Efficiency of a Preoperative Axillary Ultrasound and Fine-Needle Aspiration Cytology to Detect Patients with Extensive Axillary Lymph Node Involvement

Background

Recent studies have demonstrated that axillary lymph node dissection (ALND) does not affect patient survival, even in those with one or two positive sentinel lymph nodes (SLNs). On the other hand, patients with 3 or more metastatic lymph nodes are eligible for chemotherapy. Therefore, it is crucial to identify a priori patients at risk of having a high number of metastatic axillary lymph nodes for their surgical and/or clinical management. Ultrasound (US) guided Fine-Needle Aspiration (FNA) has been proven to be a useful and highly specific method for detecting metastatic axillary lymph nodes. However, only one recent study has evaluated the efficiency of this method in identifying patients with high metastatic nodal involvement. Our aim was to validate US-guided FNA as a reliable method to discriminate a priori patients with >3 metastatic lymph nodes.

Methods

A retrospective series of 1287 breast cancer patients who underwent a simultaneous preoperative breast and axillary US to stage their axilla was collected. A total of 365 patients, with either positive SLNs (278) or positive axillary lymph nodes detected via US-guided FNA (87), underwent ALND. In these two subgroups, we compared the number of metastatic lymph nodes in the axilla.

Results

The number of metastatic axillary lymph nodes in patients who underwent US-guided FNA was significantly higher (63% had >3 metastatic lymph nodes) than that in patients with SLNs positive for micro- or macrometastases (3% and 27%, respectively) (P<0.001, χ ² = 117.897).

Conclusions

Preoperative axillary US-guided FNA could act as a reliable tool in identifying breast cancer patients with extensive nodal involvement.