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细胞周期调节分子在手术切除的Ⅰ期和Ⅱ期乳腺癌中的预后价值

Prognostic value of cell cycle regulator molecules in surgically resected stage I and II breast cancer.

作者信息

Peters Maria Giselle, Vidal Maria del Carmen C, Giménez Liliana, Mauro Laura, Armanasco Eduardo, Cresta Carlos, Bal de Kier Joffé Elisa, Puricelli Lydia

机构信息

Area Investigación, Instituto de Oncología Angel H. Roffo, (C1417DTB) Buenos Aires, Argentina.

出版信息

Oncol Rep. 2004 Nov;12(5):1143-50.

Abstract

Success in breast cancer treatment depends greatly upon early detection, and in the employment of prognostic markers able to anticipate the evolution of the disease, allowing a more rational management of the patient. A fundamental cause of cancer is the alteration of the genetic material, which may modify the expression of proteins that play key roles in cell cycle progression. The aim of this study was to analyze the expression of cyclins D1, E, and B1 and of the CDKIs p16 and p21 in a population of uniformly treated patients with stage I or II breast tumors (n=56) compared with patients with benign breast pathology (n=23). Malignant breast tumors showed higher cyclin E and lower p21 expression than benign breast pathology (NS), determined by immunohistochemistry (IHC). In breast cancer patients, overexpression of cyclins D1 and E was associated with the presence of ER and stage respectively independently of other prognostic variables (multivariate analysis). Kaplan-Meier curves demonstrated that only overexpression of cyclin E was associated with a longer recurrence-free survival. Cox analysis showed that neither cyclins nor CDKIs were independent prognostic markers. We demonstrated that several regulators of cell cycle progression were altered in a large number of breast tumor cases, however, these abnormalities were not indicators of a worse outcome in breast cancer patients of stages I and II.

摘要

乳腺癌治疗的成功很大程度上取决于早期检测,以及使用能够预测疾病进展的预后标志物,从而实现对患者更合理的管理。癌症的一个根本原因是遗传物质的改变,这可能会改变在细胞周期进程中起关键作用的蛋白质的表达。本研究的目的是分析细胞周期蛋白D1、E和B1以及细胞周期蛋白依赖性激酶抑制剂p16和p21在一组接受统一治疗的I期或II期乳腺肿瘤患者(n = 56)中的表达,并与乳腺良性病变患者(n = 23)进行比较。通过免疫组织化学(IHC)测定,恶性乳腺肿瘤的细胞周期蛋白E表达高于乳腺良性病变,而p21表达低于乳腺良性病变(无统计学意义)。在乳腺癌患者中,细胞周期蛋白D1和E的过表达分别与雌激素受体(ER)的存在和分期相关,独立于其他预后变量(多变量分析)。Kaplan-Meier曲线表明,只有细胞周期蛋白E的过表达与更长的无复发生存期相关。Cox分析表明,细胞周期蛋白和细胞周期蛋白依赖性激酶抑制剂均不是独立的预后标志物。我们证明,在大量乳腺肿瘤病例中,细胞周期进程的几种调节因子发生了改变,然而,这些异常并不是I期和II期乳腺癌患者预后较差的指标。

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