目的：研究乳腺非特殊类型浸润性癌（invasive carcinoma of no special type, ICNST）组织中性别决定区Y框蛋白（sex determining region Y-box 2, SOX-2）的免疫组织化学（免疫组化）表达, 并分析其与临床病理参数及乳腺癌分子分型间的关系。方法：收集正常乳腺组织标本30例及2005年1月至2012年12月期间在南京军区南京总医院诊治的179 例ICNST患者的病理标本及完整临床病理资料, 通过免疫组化检测ICNST组织中SOX-2及雌激素受体（estrogen receptor, ER）、孕激素受体（progesterone receptor, PR）、人类生长因子受体2（human epidermal growth factor receptor 2, Her-2）、Ki-67蛋白表达情况, 分析包括年龄、临床分期、月经状态、淋巴结转移、组织学分级、复发、死亡情况及ER、PR、Her-2、Ki-67表达结果与SOX-2表达间的关系。结果：SOX-2在乳腺ICNST癌组织中的表达率（34.6%, 62/179）比正常乳腺中明显升高（P<0.05）, 且SOX-2蛋白表达与乳腺癌是否复发、淋巴结转移及临床分期有关（P<0.05）, 而与组织学分级、年龄、绝经状态、肿瘤直径、Her-2、Ki-67、ER、PR及乳腺癌分子分型无关;Kaplan-Meier法分析显示, SOX-2阳性组较阴性组的无病生存时间及总生存时间缩短（P<0.05）;COX回归分析显示, SOX-2表达水平是影响乳腺癌患者无病生存期的独立预后影响因素(P<0.05)。结论：SOX-2的表达与ICNST的发生、进展、复发和转移密切相关, 可能成为评价乳腺癌预后的重要分子生物学标志物, 并为乳腺癌的研究等提供新思路。
Objective: To study the expression of SOX-2 (sex determining region Y-box) in breast invasive carcinoma of no special type (ICNST) and analyze its significance and relationship with ER, PR, Her-2, Ki-67 and clinicopathological features. Methods: Normal breast tissue specimens (30 cases) and ICNST specimens of 179 patients and their complete clinical and pathological data during the period from January 2005 to December 2012 at Nanjing General Hospital of Nanjing Military Command were collected. The clinicopathological features included age, menstrual status, clinical stage, recurrence, metastasis, death, and expressions of ER, PR, Ki-67 and Her-2. The expressions of SOX-2, ER, PR, Ki-67 and Her-2 were detected by immunohistochemistry. Analysis of the clinicopathological features in association with SOX-2 expression was performed. Results: The expression of SOX-2 was significantly higher in ICNST cancer tissues than that in normal breast tissue (P<0.05). SOX-2 expression in ICNST was correlated with recurrence, lymph node metastasis and clinical staging (P<0.05), while had no significant correlation with histological grade, age, menopausal status, tumor size, ER, PR, Her-2, Ki-67 and molecular typing. Kaplan-Meier analysis showed that disease free survival time and total survival time in SOX-2 positive group were shorter than that in SOX-2 negative group (P<0.05). COX analysis revealed that SOX-2 was an independent prognostic factor affecting disease-free survival of ICNST(P<0.05). Conclusions: The expression of SOX-2 is closely correlated with occurrence, progression, recurrence and metastasis of ICNST. It may become an important biological marker for evaluating the prognosis of breast cancer and create new ideas for breast cancer research.
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