结合素-4（nectin-4）在乳腺癌中表达及其临床意义研究

目的：观察乳腺癌患者血清及乳腺组织中结合素4的表达并探讨其临床意义。方法：选择2007年6月至2008年12月哈尔滨医科大学附属三院收集的40例乳腺癌患者和20例乳腺良性肿瘤患者为研究对象，分为正常对照组、乳腺癌组、乳腺良性肿瘤组，采用Elisa法和免疫组化法对所选择的血清及组织标本中nectin-4及血清中癌胚抗原（CEA）、CA153的表达进行检测。结果：（1）nectin-4的阳性表达定位于细胞质和细胞膜，其在乳腺癌组织中的阳性表达率显著高于乳腺良性组织（P〈0．05）；nectin-4的表达与患者的年龄、临床分期无关（P〉0．05），但与乳腺癌的病理类型、腋窝淋巴结转移与否、Her-2、ER和PR的表达均显著相关（P〈0．05）。②乳腺癌组血清nectin-4表达水平最高，为238＋4．95pg／ml；乳腺良性病变组为1205：3．28pg／ml；正常对照组为104±5．86pg／ml，三者之间比较，差别有统计学意义（P〈0．01）。③与正常对照组、乳腺良性病变组比较，乳腺癌组血清CEA、CAl53水平均明显升高，差异有显著统计学意义（P〈0．01）。④nectin-4、CEA和CA153诊断乳腺癌的敏感性分别为31．67％、43-33％、28．33％，特异性分别为92．50％、95％、95％，三者联合检测诊断乳腺癌的敏感性较单独检测显著升高（P〈0．05），可达81．67％。结论：Nectin-4在乳腺癌中高表达，且与乳腺癌的病理类型、腋窝淋巴结转移与否、Her-2、ER和PR的表达均呈显著相关，通过联合检测血清nectin-4、CEA和CA153水平可显著提高乳腺癌诊断的敏感性，有助于乳腺癌的治疗和预后评估，值得临床进一步深入研究。

Study on the Expression and Clinical Significance of Nectin-4 in Breast Cancer

Objective： To observe the expression and clinical significance of nectin-4 in breast cancer. Methods： 40 cases of breast cancer and 20 cases of benign breast tumor patients admitted from June 2007 to December 2008, in Harbin Medical University were collected and divided into the normal control group, the breast cancer group, and benign breast tumor group. Elisa method and immunohistochemical method were used to detect the nectin expression in serum and tissue and serum carcinoembryonic antigen （CEA）, CA153 expression. Results： （1）The positive expression of nectin located in the cytoplasm and cell membrane, the positive rate of nectin expression in breast cancer tissue was significantly higher than that in the benign breast tissue（P〈0.05）; no correlation was found between nectin-4 expression and the patient＇s age, clinical stage（P〉0.05）, which was significantly related to the pathological type of breast cancer, axillary lymph node metastasis, Her-2, ER and PR expression （P〈0.05）. （2）The serum nectin-4 level was highest in breast cancer group, which was 238＋ 4.95 pg/mL; they were 120＋ 3.28 and 104± 5.86 pg/mL in benign breast lesions group and healthy control group respectively （P〈0.01）. （3）Compared with the normal control group, benign breast disease group, the serum CEA, CA153 levels in breast cancer group were significantly higher （P〈0.01）. （4） The sensitivity of nectin-4, CEA and CA153 in the diagnosis of breast cancer were 31.67%, 43.33%, 28.33% respectively, the specificity were 92.50%, 95%, 95% respectively, the sensitivity of combined detection was significantly higher than nectin-4, CEA and CA153 alone （P〈0.05）, which was 81.67%. Conclusion： High expression of Nectin-4 was found in the breast cancer, which was correlated with the pathological type, axillary lymph node metastasis, Her-2, ER and PR expression, combined detection of serum nectin-4, CEA and CA153 levels could significantly improve the sensitivity of the diagnosis of breast cancer, and contribute to the treatment and prognosis evaluation of breast cancer.