| Background:Parathyroid hormone related protein is a secreted protein widely expressed in normal human tissues to participate in growth and development of multiple tissues and organs in process of life. Many malignant tumors such as breast cancer, lung cancer, prostate cancer, kidney cancer and ovarian cancer produce PTHrP which especially have a close relationship with bone metastasis of breast cancer and is main cause of hypocalcaemia malignant tumor. PTHrP, however, for the influence of primary breast cancer progression still exist many dispute. So the further study of the subject will deepen our understanding of breast cancer growth-infiltration-metastasis process, so as to have a positive effect of breast cancer diagnosis and treatment.Objective:By comparing the different expression of PTHrP in ductal carcinoma in situ, invasive breast cancer and breast cancer with bone metastases, and analyzing the relationship between PHTrP and clinical pathological of breast cancer, discuss its biological character in breast cancer growth-infiltration-metastases process and its significance on prognostic assessment, to provide theoretical basis for prognosis assessment and individualized treatment in clinical.Methods:Collect45cases of primary tumor tissue which first diagnosis for breast cancer with bone metastasis,60cases of ductal carcinoma in situ tissue and60cases of invasive breast cancer without metastasis tissue as control group. All cases were collected in breast surgery of Xiangya hospital from January2010-June2013. All specimens were diagnosed by definite pathological diagnosis and inmmunohistochemical detection of ER, PR, Her-2and Ki67. All bone metastasis cases were diagnosed by radionuclide bone imaging and other imaging diagnosis. Use immunohistochemical S-P method test PTHrP expression in three groups’breast cancer tissue, so as to retrospectively analyze the characteristics of PTHrP’s expression and the relationship with clinic pathological features of primary tumors.Results:PTHrP expression among45cases of breast cancer with bone metastases tissue, the "-" account for22.2%(10/45), the "+" account for4.4%(2/45), the "++" account for28.9%(13/45), the "+++’ account for44.4%(20/45); PTHrP expression among60cases of ductal carcinoma in situ tissue, the "-" account for13.3%(8/60), the "+" account for16.7%(10/60), the "++" account for43.3%(26/60), the "+++" account for26.7%(16/60); PTHrP expression among60cases of invasive breast cancer without metastasis tissue in control group, the "-account for73.3%(44/60), the "+" account for18.3%(11/60), the "++’ account for5.0%(3/60), the "+++" account for3.3%(2/60). PTHrP expression between breast cancer with bone metastasis cases, ductal carcinoma in situ cases and invasive breast cancer without metastasis cases have a significant statistical difference (P<0.01). In breast cancer with bone metastasis cases PTHrP expression negatively correlated with PR expression (rs=-0.368, P<0.05) and positively correlated with Ki67expression (rs=0.407, P<0.05). Age, tumor size, lymph node metastasis, histological grading, menopausal status, family history, other metastases, ER and Her-2expressions has no relevance. In ductal carcinoma in situ cases PTHrP expression positively correlated with ER expression (rs=0.443, P<0.05) and PR expression (rs=0.475, P<0.05), and negatively correlated with Ki67expression (rs=-0.256, P<0.05), Age, tumor size, lymph node metastasis, histological grade, menopausal status, family history, Her-2expression has no relevance. In invasive breast cancer without metastasis cases PTHrP expression positively correlated with lymph node metastasis (rs=0.471, P<0.05), and negatively correlated with menopausal status (rs=-0.294, P<0.05), Age, tumor size, histological grade,,family history, ER expression, PR expression, Her-2expression and Ki67expression has no relevance. Multiple factors regression analysis showed that histological grade, lymph node metastasis, ER and PTHrP expression are the independent factors affecting bone metastasis of breast cancer(P<0.05), while age, tumor size, menopausal status, family history, PR, Her-2and Ki67expression are not independent factors. As well as PTHrP expression is the independent factor affecting breast cancer invasion (P<0.05), while age, tumor size, menopausal status, family history, ER, PR, Her-2and Ki67expression are not independent factors.Conclusion:1. PTHrP is an important factor influencing the progression and bone metastases in breast cancer.2. PTHrP positive expression plays a promoting role in the process of bone metastases in invasive breast cancer. |
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