探讨趋化因子CXCL12/CXCR4、DNA拓扑异构酶Ⅱα(TopoⅡ α)、核因子κB(NF-κB)在三阴性乳腺癌(TNBC)组织中的表达的意义。

53例TNBC患者为TNBC组，76例非三阴性乳腺癌(N-TNBC)患者为N-TNBC组。取患者手术切除病灶标本进行免疫组织化学染色，分别检测组织中CXCL12/CXCR4、TopoⅡ α、NF－κB蛋白水平。自术后开始随访，记录术后复发、转移、死亡情况，死亡患者以截尾数据统计，存活患者至少随访3年，统计患者复发转移及死亡率，比较各组无病生存时间(DFS)。采用SPSS 17.0统计软件对数据进行分析，组间率以及按不同临床病理指标分组后的比较均采用χ²检验和Fisher精确概率法检验，DFS采用均数±标准差表示，组间比较采用配对样本的t检验。

TNBC组≤50岁患者所占比例高、淋巴结转移较早、浸润性导管癌、临床分期以Ⅲ期多见。TNBC组CXCL12、CXCR4、TopoⅡα、NF-κB阳性细胞比例分别为66.04%、84.91%、69.81%、79.25%，N-TNBC组比例分别为40.79%、51.32%、40.79%、51.32%，TNBC组阳性细胞比例高于N-TNBC组，差异有统计学意义(χ² ＝7.97，15.51，10.55，10.43；P<0.01)。TNBC组复发转移率、死亡率、DFS分别为20.75%、28.30%、(24.35±3.50)月，N-TNBC组分别为11.32%、13.16%、(32.02±4.00)月，TNBC组复发转移率、死亡率均高于N-TNBC组，差异有统计学意义(χ²＝4.51，4.58；P<0.05)，DFS少于N-TNBC组(t＝5.29，P<0.05)；CXCL12、CXCR4、TopoⅡα、NF-κB阳性表达组复发转移率分别为19.70%、17.86%、19.12%、18.52%，阴性表达组分别为6.35%、4.44%、6.56%、4.17%，阳性表达组均高于阴性表达组 (χ²＝5.02，4.61，4.43，5.43；P<0.05)；阳性表达组死亡率分别为27.27%、25.00%、26.47%、24.69%，阴性表达组分别为11.11%、8.89%、11.48%、10.42%，阳性表达组均高于阴性表达组 (χ²＝5.39，4.87，4.63，3.93；P<0.05)；阳性表达组DFS分别为(23.17±3.30)月、(24.50±3.21)月、(23.51±3.65)月、(25.36±3.65)月，阴性表达组分别为(32.25±3.55)月、(33.00±4.15)月、(35.00±5.10)月、(31.86±4.57)月，阳性表达组均少于阴性表达组 (t＝5.37，5.80，6.21，5.08；P<0.05)。

TNBC患者癌灶组织中CXCL12、CXCR4、TopoⅡ α、NF-κB呈高表达状态，且阳性表达者复发转移较早，预后不佳，这可能与其增加肿瘤细胞的侵袭能力、介导淋巴结特异性转移有关。

To explore the meaning of the expression of CXCL12/CXCR4, Topo Ⅱα, NF-κB in tissues of triple negative breast carcinoma (TNBC).

Fifty-three cases with TNBC were enrolled as TNBC group, and seventy-six cases with non-triple negative breast carcinoma (N-TNBC) as N-TNBC group.Immunohistochemical stainings were conducted with resection specimens, and proteins of CXCL12/CXCR4, Topo Ⅱ α, NF-κB were detected.Patients were followed up after surgery to record postoperative recurrence, metastasis and death.The death cases were recorded by censored data, and surviving cases were followed up for 3 years at least.Rates of recurrence and metastasis, mortality, and disease free survival time (DFS) were compared among different groups.

Less than or equal to 50 years old, lymph node metastasis, invasive ductal carcinoma and Ⅲ stage were TNBC patients′ main features.Positive cells of CXCL12, CXCR4, Topo Ⅱ α, NF-κB were 66.04%, 84.91%, 69.81%, 79.25% respectively in TNBC group, and were 40.79%, 51.32%, 40.79%, 51.32% in N-TNBC group.Positive cells of CXCL12, CXCR4, Topo Ⅱ α, NF-κB in TNBC group were all higher than those in N-TNBC group (χ²=7.97, 15.51, 10.55, 10.43; P<0.05). Metastasis rate, mortality and DFS were 20.75%, 28.30%, (24.35±3.50)months respectively in TNBC group, and were 11.32%, 13.16%, (32.02±4.00)months in N-TNBC group.Metastasis rate, mortality in TNBC group were both greater than those in N-TNBC group (χ²=4.51, 4.58; P<0.05), yet DFS was less than that in N-TNBC group (t=5.29, P<0.05). Rates of recurrence and metastasis in positive expression groups of CXCL12, CXCR4, Topo Ⅱ α, NF-κB were 19.70%, 17.86%, 19.12%, 18.52%, and were 6.35%, 4.44%, 6.56%, 4.17% in negative expression groups, and they were all more significant than those in negative expression groups (χ²=5.02, 4.61, 4.43, 5.43; P<0.05). Mortality was 27.27%, 25.00%, 26.47%, 24.69% in positive expression groups, and was 11.11%, 8.89%, 11.48%, 10.42% in negative expression groups, and they were all bigger than those in negative expression groups (χ²=5.39, 4.87, 4.63, 3.93; P<0.05). DFS were (23.17±3.30)months, (24.50±3.21)months, (23.51±3.65)months, (25.36±3.65)months in positive expression groups, and were(32.25±3.55)months, (33.00±4.15)months, (35.00±5.10)months, (31.86±4.57)months in negative groups, and the differences between the two groups were statistically significant (t=5.37, 5.80, 6.21, 5.08; P<0.05).

There are high expression of CXCL12, CXCR4, Topo Ⅱ α, NF-κB in tissue of TNBC, with early recurrence and metastasis and poor prognosis, and it may be related with increasing tumor cells′ invasive ability and mediating specific metastasis of lymph node.