Study on the skip metastasis of axillary lymph nodes in breast cancer and their relation with Gli1 expression
Study on the skip metastasis of axillary lymph nodes in breast cancer and their relation with Gli1 expression
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乳腺癌腋窝淋巴结跳跃转移及其与Gli1表达的关系研究
DOI：
10.1007/s13277-012-0455-7
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发表时间：
2012-07
期刊：
影响因子：
--
通讯作者：
Li, Ji-Guang
中科院分区：
文献类型：
--
作者：
Zhao, Ting-Ting;Zheng, Xin-Yu;Jin, Feng;Li, Ji-Guang
乳腺癌腋窝淋巴结跳跃性转移（SM）是一种重要的肿瘤现象，对正确选择手术切除至关重要。ALN的SM机制尚不清楚。Gli1蛋白是一种核心的上皮-间质转化（EMT）调节因子，在肿瘤的发育和疾病过程中起重要作用，并与肿瘤转移有关。本研究旨在探讨SM的临床病理特征，并探讨Gli1表达在乳腺癌ALN转移患者中的意义。本文回顾性分析了1037例接受根治性乳房切除术的女性乳腺癌患者的临床病理资料。在本研究中，SM被定义为I级缺席，但II级和/或III级参与。采用免疫组化方法对102例淋巴结阳性的非SM患者和33例SM患者的Gli1表达进行检测。在单因素分析中，我们发现pN类型、TNM分期、内在亚型和Gli1表达是SM的重要危险因素。进一步的logistic回归分析显示，相对于腔内b1 （HER2阴性）患者，腔内A患者发生SM的风险较低。进一步的多因素分析显示，Gli1的表达和阳性淋巴结数量是与SM相关的独立因素。总的来说，乳腺癌伴ALN的SM与腔内B1的内在亚型相关。Gli1表达与SM伴乳腺癌发生过程相关，可作为SM伴ALN乳腺癌的预测因子。
The skip metastasis (SM) of axillary lymph nodes (ALN) in breast cancer is an important phenomenon which is crucial to determine the correct choice of surgical resection. The mechanism of SM of ALN is unclear. Gli1 protein is a core epithelial-to-mesenchymal transition (EMT) regulatory factor that plays essential roles in both development and disease processes and has been associated with metastasis in carcinomas. The aim of this study was to investigate the clinicopathological characteristics of SM and evaluate the significance of Gli1 expression in breast cancer patients with metastasis of ALN. Clinicopathological data from 1,037 female breast cancer patients who underwent radical mastectomy were retrospectively reviewed. In this study, an SM was defined as level I absence but level II and/or level III involvement. The expression of Gli1 was evaluated by immunohistochemistry in 102 non-SM cases with positive nodes and 33 SM cases. In univariate analysis, we found that pN category, TNM stage, intrinsic subtypes and Gli1 expression was significant risk factor of SM. Further logistic regression analysis revealed that luminal A cases had a lower risk of SM relative to luminal B 1 (HER2 negative) cases. Further multivariate analysis revealed that Gli1 expression and numbers of positive lymph nodes were the independent factors which associated with SM. Collectively, Breast cancer with SM of ALN associated with the intrinsic subtype of the luminal B1. Gli1 expression related with the procession of breast cancer with SM, which can be used as a predictor of SM of ALN in breast cancer.
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