| Background and Purpose:In the global female malignant tumor, breast cancer is the most common malignant tumor and occupies the first place of the feminine malignant tumor. In recent years, the incidence rate of breast cancer is offering the trend of escalation; the morbidity age is youth and youth. At present, because the biological indicator of early diagnosis and the judgment prognosis lack, the majority of breast cancer patient for the first time occupy intermediate stage or advanced stage. Breast cancer designated object examination has the important significance for the auxiliary diagnosis, the instruction treatment and the judgment prognosis. They also reflect the tumor the biology characteristic. The occurrence and development of breast cancer is a complex processes, anti- apoptosis is one of committed steps which breast cancer cell realizes invasion, metastasis and reduplication. Until now survivin is the strongest apoptosis inhibiting factor, its organization distribution has the obvious cell selectivity, mainly in embryo, growth embryo organization and majority tumor organizations. Survivin may inhibit cell apoptosis, promote cell transformation and participate cell's mitosis, blood vessel's production, tumor cell drug resistance production and so on.The cell adhesion molecule CD44 is the widespread membrane surface single stranded glycoprotein, divided into the standard type (standard form of CD44, CD44s) and the variation type (splicing variant of CD44, CD44v).The CD44 variation body (CD44v6) is one kind of multi-purpose cross membrane glycoprotein of cell surface, it is the important member of the cell adherency molecule family, and widely distribute in the white blood cell, the epithelial cell and the endothelial cell, Moreover, they participate specificity adhesion process between participation cell and cell, cell and matrix through specific binding hyaluric of extracellular matrix, it is the non-uniformity adherency, namely neoplastic cell and host cell and host matrix adherency, non-uniformity adherency has influential role in cancer cell invasion and metastasis process.Vascular endothelial growth factor (VEGF) is one kind of growth factor which can affect specially in the blood vessel endothelial cell, and has influential role in tumor newborn vascularization process. Folkman proposed hypothesis that the tumor growth depended on blood vessel newborn in 1971. From now on, the research that will produce about the tumor blood vessel is going to begin the prologue. In numerously the blood vessel production factor, VEGF and its acceptor are the key factor which lead the newborn vascularization, they urge the blood vessel endothelial cell mitosis and form the newborn blood vessel finally; VEGF is the strongest cell factor which stimulates the tumor blood vessel production. After VEGF and its acceptor union, they stimulate the blood vessel endothelial cell proliferation, promote the vascularization and increase the blood vessel permeability, which causes the tumor cell easily to penetrate to the blood vessel, and has provided the opportunity to the tumor metastasis. In recent years, the massive findings indicated that the blood vessel production is also playing the very vital role in breast cancer's occurrence and development. Therefore, in breast cancer research certain multiple factors of blood vessel production forecast prognosis as well as treats breast cancer by the anti-blood vessel generator have become another hot spot in recent years.This research plan is to use the immunity histochemical method (the S-P law) to examine the change characteristic of CD44v6,Survivin and VEGF in breast cancer organizes, and discusses the relevance of CD44v6, Survivin and VEGF in breast cancer's occurrence, the development and the prognosis. Moreover, it increases molecular mechanism's understanding to breast cancer multi-phased evolution, and provides the important rationale and the method for the clinical breast cancer biological controls.Materials and methods:60 cases of breast cancer specimens were from the First Affiliated Hospital of Zhengzhou University from March 2006 to January 2007 resected specimens, all of them are female, aged 34-75 years with a mean age of 50 years, patients were not received other treatment before surgery. Formalin-fixed, paraffin-embeded, serial sections can be used to carry out histopathological and immunohistochemical examination. Immunohistochemical SP method in detecting breast cancer can use tissue CD44v6, Survivin and VEGF expression. Using statistical software SPSS 11.5 processing rate of each group compared with theχ2 test, small samples using direct probability method,α=0.05 as a test.Results:1. The Survivin expression is mainly located in the cytoplasma, the positive sign for the cytoplasma appear brown granules, and the positive expression rate of Survivin is 70.00%(42/60). By the histology grades in the immune response in breast cancer, the positive rate ofⅠ+ⅡLevel is 69.23%(36/52),ⅢLevel 75.00%(6/8), the groups no significant difference (P>0.05). The survivin protein in≤45 year-old group's masculine expression rate is 69.23%(18/26); In the>45 year-old group's masculine expression rate is 70.59%(24/34), the groups in different age patient no significant difference (P>0.05). Survivin in regional lymph node metastasis group, the positive rate is 89.29%(25/28), in non-lymph node metastasis group, the positive rate is 53.13% (17/32), both of positive expression are significantly different (P<0.05). The rate of Survivin protein in ER positive group is 61.11%(22/36), The rate of Survivin protein in PR positive group is 76.92%(20/26), Survivin expression and ER, PR expression are no statistically significant (P> 0.05).2.The CD44v6 expression is located in the cytoplasma or cell membrane, the positive sign for the cytoplasma or cell membrane appear brown granules, and the positive expression rate of CD44v6 is 61.67%(37/60). By the histology grades in the immune response in breast cancer the positive rate ofⅠ+ⅡLevel is 61.54%(32/52),ⅢLevel 62.50%(5/8), the groups no significant difference (P>0.05). The CD44v6 protein in≤45 year-old group's masculine expression rate is 73.08%(19/26); In the>45 year-old group's masculine expression rate is 52.94%(18/34), the groups in different age patient no significant difference (P>0.05). CD44v6 in regional lymph node metastasis group, the positive rate is 78.57%(22/28), in non-lymph node metastasis group, the positive rate is 46.88% (15/32),both of positive expression are significantly different (P <0.05).The rate of CD44v6 protein in PR positive group is 73.08%(19/26), in PR negative group is 52.94%(18/34), both of the positive expression and the negative expression are statistically significant (P< 0.05).3. The VEGF expression is located in the cell membrane, the positive sign for the cell membrane appear brown granules, and the positive expression rate of VEGF is 81.67%(49/60). By the histology grades in the immune response in breast cancer the positive rate ofⅠ+ⅡLevel is 80.77%(42/52),ⅢLevel 87.50%(7/8), the groups no significant difference (P> 0.05). The VEGF protein in≤45 year-old group's masculine expression rate is 88.46%(23/26); In the>45 year-old group's masculine expression rate is 76.47%(26/34), the groups in different age patient no significant difference (P> 0.05). VEGF in regional lymph node metastasis group, the positive rate is 92.86%(26/28), in non-lymph node metastasis group, the positive rate is 71.88% (23/32),both of positive expression are significantly different (P< 0.05). The rate of VEGF protein in ER positive group is 72.22%(26/36), in ER negative group is 95.83%(23/24), both of the positive expression and the negative expression are statistically significant(P<0.05).4. The Survivin protein expression and the VEGF protein expression have the remarkable relevance (P<0.05). VEGF protein expression and the CD44v6 protein expression has the remarkable relevance (P<0.05).Conclusion:1.Overexpression of Survivin, CD44v6 and VEGF protein in breast cancer,and the positive expression rate in breast cancer with lymph node metastasis is higher than that of without non-lymph node metastasis, suggesting that the three involved in the occurrence of breast cancer, the development process, breast cancer invasion, metastasis and prognosis.2.VEGF protein expression was correlated with Survivin and CD44v6, so routine testing Survivin, CD44v6 and VEGF to breast cancer tissue help to assess the biological behavior of breast cancer and determine the prognosis of breast cancer. |
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