目的：探讨p53，Ki-67及E-钙黏蛋白(E-cadherin)在三阴性乳腺癌(triple negative breast cancer，TNBC)组织中的表达及预后的关系。方法：采用免疫组织化学法检测52例TNBC和52例非三阴性乳腺癌(non-triple-negative breast cancer，NTNBC)组织中p53，Ki-67及E-cadherin表达情况，观察3个指标与TNBC患者临床病理学特征及预后的关系。结果：TNBC组织中p53，Ki-67及E-cadherin的阳性表达率分别为67.3%，80.8%，26.9%；而在NTNBC组织中为44.2%，61.5%，48.1%(均P<0.05)。在TNBC组织中，p53表达阳性与肿瘤大小、TNM分期及组织学分级有关(均P<0.05)；Ki-67表达阳性与TNM分期、淋巴结转移有关(均P<0.05)；E-cadherin表达阳性与肿瘤大小、TNM分期、淋巴结转移有关(均P<0.05)。在TNBC患者中，p53，Ki-67及E-cadherin表达阳性者与阴性者总体生存率(overall survival，OS)的差异均有统计学意义(P<0.05)。Cox回归分析多因素显示：淋巴结转移、p53、Ki-67及E-cadherin表达是影响TNBC患者总体生存率的独立预后因素(均P<0.05)。结论：TNBC组织中，p53、Ki-67高表达，其表达阳性者预后差，E-cadherin低表达，其表达阳性者预后良好。联合检测p53、Ki-67及E-cadherin表达可为TNBC患者的治疗提供新靶点。
Expression and prognosis of p53, Ki-67 and E-cadherin in triple-negative breast cancer
Objective: To investigate the expression of p53, Ki-67, E-cadherin and their prognostic value in triple negative breast cancer (TNBC). Methods: The expression of p53, Ki-67, E-cadherin was assessed by immunohistochemistry in 52 cases of TNBC and 52 cases of non-triple negative breast cancer (NTNBC). The association of the clinicopathological variables and the prognostic value of p53, Ki-67 and E-cadherin expression were evaluated in TNBC. Results: The positive expression rates of p53, Ki-67, E-cadherin in TNBC were 67.3%, 80.8%, 26.9%, while the positive expression rates of those in NTNBC were 44.2%, 61.5%, 48.1% (all P<0.05). In TNBC, p53 expression was associated with tumor size, TNM stage and histological grade (all P<0.05), Ki-67 expression was associated with TNM stage and lymph node metastasis (both P<0.05), and E-cadherin expression was correlated with tumor size, TNM stage, and lymph node metastasis (all P<0.05). In TNBC, there was significant difference in overall survival (OS) of the positive and negative p53, Ki-67 and E-cadherin patients (all P<0.05). Cox regression was used for analysis of factors for TNBC patients. Expression of lymph node metastasis, p53, Ki-67, E-cadherin are independent prognostic factor affecting overall survival of TNBC according to Cox regression analysis of multiple factors (all P<0.05). Conclusion: In TNBC, the high expression of p53, Ki-67 has poor prognosis, while the low expression of E-cadherin has good prognosis. Therefore, our data suggests that the combined examination of p53, Ki-67 and E-cadherin expression might be useful prognostic markers in TNBC and might provide molecular targeting therapy of TNBC treatment.