关键词: 绝经期, 乳腺肿瘤, 激素受体, 人表皮生长因子受体-2, p53蛋白

Abstract: Objective The aim of this study was to investigate the predictive value of p53 protein expression in postmenopausal hormone receptor(HR)positive and HER-2 positive postoperative breast cancer patients with adjuvant endocrine drugs.Methods A total of 172 cases of postoperative breast cancer patients were collected in Harbin Medical University Cancer Hospital from January 2005 to December 2011.All patients were postmenopausal,including 84 patients received aromatase inhibitors(AI)treatment and 88 patients received tamoxifen(TAM)treatment.The median follow-up time was 68 months(4~131 months).χ² test was used to analyze the relationship between p53 protein expression and the clinicopathological features of breast cancer.Kaplan-Meire analysis,Log-rank test and Cox regression model were used for survival analysis.Results The expression of p53 protein was not correlated with tumor size,lymph node status,histological grade,ER and PR expression.Cox univariate analysis showed that p53 protein was related to lymph node status(χ²=46.602;P＜0.001)and radiation therapy(χ²=9.617;P=0.002).But p53 expression was not associated with DFS in breast cancer patients(χ²=0.002,P=0.968).Cox multivariate analysis showed that DFS was only associated with lymph node metastasis in breast cancer patients(HR=2.121,95%CI:1.630~2.760,P＜0.001).Subgroup analysis showed that DFS in patients with p53-positive was superior to patients with p53-negative in oral TAM(χ²=4.695,P=0.030).In patients with oral AI,DFS in with p53-negative patients was superior to p53-positive patients(χ²= 5.995,P=0.014).Conclusion The positive expression of p53 protein is a predictor of effective treatment of TAM,while the negative expression of p53 protein is a predictor of effective treatment of AI.

Key words: Menopause, Breast neoplasms, Hormone receptor, Human epidermal growth factor receptor-2, p53 protein