盛贤能　郭宇　鲁杨　王金秋

[摘要] 目的 探討C-erbB-2、p-Akt蛋白在乳腺癌中的表达水平及其在保留NAC乳腺癌手术中的临床意义。 方法 自2010年6月～2011年3月，随机选择86例经穿刺病理诊断确诊乳腺非浸润性导管癌，且符合保留NAC乳腺癌手术的女性患者为患者组。在我院健康体检中心随机选择86例健康女性为健康对照组。对患者组患者进行保留NAC乳腺癌手术，术后对癌组织及癌旁正常组织进行免疫组化染色。检测C-erbB-2、p-Akt蛋白在癌组织及癌旁正常组织中的表达水平。使用ELISA法对患者手术前后及健康对照组外周血的C-erbB-2、p-Akt表达水平进行检测，记录各组数据并进行统计学分析。按照C-erbB-2、p-Akt表达情况分为双阳性、双阴性以及单阳性。使用Kaplan-Meier法分析患者生存预后。 结果 在乳腺癌组织及癌旁正常组织中，C-erbB-2、p-Akt蛋白均有表达，但在癌组织表达水平明显高于正常组织，差异具有统计学意义（P<0.05）。乳腺癌患者外周血C-erbB-2、p-Akt与健康对照组相比均明显升高。Kaplan-Meier法分析患者生存预后发现，C-erbB-2、p-Akt均阳性表达者生存率明显降低，总生存期明显缩短，差异具有统计学意义（P<0.05）。 结论 乳腺癌患者外周血C-erbB-2、p-Akt水平明显高于健康对照组，C-erbB-2、p-Akt对患者接受保留NAC乳腺癌术后生存期有重要的临床意义。

[关键词] 乳腺癌；C-erbB-2；p-Akt；乳头乳晕复合体

[中图分类号] R737.9 [文献标识码] A [文章编号] 1673-9701（2017）12-0001-04

[Abstract] Objective To investigate the expression level of C-erbB-2 and p-Akt proteins in breast cancer and its clinical significance in breast cancer surgery reserving NAC. Methods From June 2010 to March 2011， 86 patients who were diagnosed with noninvasive ductal carcinoma of the mammary gland by biopsy pathological diagnosis and eligible for breast cancer surgery reserving NAC were randomly selected as the patients group. Another 86 healthy women were selected as the control group， randomly selected from the Physical Examination Center in our hospital. The enrolled patients were given the breast cancer surgery reserving NAC. Immunohistochemical staining was performed on cancer tissues and adjacent normal tissues after the surgery. The expression levels of C-erbB-2 and p-Akt in cancer tissues and adjacent normal tissues were detected， and the expression levels of C-erbB-2 and p-Akt in the peripheral blood before and after the surgery and in the healthy control group were detected by ELISA. The data of each group were recorded and analyzed statistically. According to the expression of C-erbB-2 and p-Akt， the expression was divided into double positive， double negative and single positive. Kaplan-Meier method was used to analyze the prognosis of patients. Results C-erbB-2 and p-Akt proteins were expressed in breast cancer tissues and adjacent normal tissues， but the expression levels in cancer tissues were significantly higher than those in normal tissues. The difference was statistically significant（P<0.05）. The levels of C-erbB-2 and p-Akt in the peripheral blood of patients with breast cancer were significantly higher than those in the healthy control group. Kaplan-Meier method was used to analyze the survival prognosis， indicating that the survival rate of the patients with positive C-erbB-2 and p-Akt was significantly decreased， the overall survival time was significantly shorter， and the difference was statistically significant （P<0.05）. Conclusion The levels of C-erbB-2 and p-Akt in peripheral blood of the patients with breast cancer are significantly higher than those in healthy control group， and C-erbB-2 and p-Akt have important clinical significance in the postoperative survival period of the patients receiving breast cancer reserving NAC.

[Key words] Breast cancer； C-erbB-2； p-Akt； Nipple-areola complex （NAC）

乳腺癌是指乳腺上皮细胞的恶性肿瘤，占女性所有恶性肿瘤的20%以上，成为威胁女性身体健康的重要杀手[1]。随着乳腺癌患者对生活质量的要求越来越高，患者对术后美观程度的要求也越来越高，保留乳头乳晕复合体的乳腺癌根治术也得到了广泛的应用[2]。保留乳头乳晕复合体（nipple-areolar complex， NAC）对乳腺癌患者乳房重建的美容效果和术后生活质量有重要意义。但是保留NAC的乳腺癌术后风险即复发研究尚不明确[3]。因此，探讨保留NAC的乳腺癌术后标志物对于研究其发病机制以及疾病预后具有重要的临床意义[4]。……