MIF在不同分子分型乳腺癌中的表达和意义
Expression of MIF in molecular subtypes of breast cancer and its clinical significance

摘要：目的 研究巨噬细胞移动抑制因子(MIF)在不同分子分型乳腺癌中的表达和临床意义，探索不同分型乳腺癌的分子生物学特征。方法 应用免疫组化SP法将100例乳腺癌标本分为Luminal型、HER2(+)型、BLs型和NBLs型，检测MIF表达差异。比较不同年龄、月经状况、肿瘤大小、腋窝淋巴结转移状态、肿瘤组织学类型、组织学分级和术后临床分期患者中MIF阳性表达率；比较MIF阳性患者和阴性患者的微血管密度(MVD)数值差别及5年总生存率。结果 不同分子分型和不同淋巴结转移状态的乳腺癌患者中，MIF阳性表达率有统计学差异(P<0.05)。MIF表达与HER2(+)型乳腺癌及腋窝淋巴结转移皆正相关。MIF阳性者的MVD值明显高于阴性者(P<0.05)。Kaplan-Meier法示MIF阴性者的5年生存率明显高于MIF阳性者(Log-rank=19.516，P=0.000)。结论 MIF阳性的乳腺癌患者多为HER2(+)型，易发生腋窝淋巴结转移，肿瘤新生血管明显，预后不良。
ABSTRACT: Objective To determine the expression of macrophage migration inhibitory factor (MIF) in different molecular subtypes of breast cancer and its clinical significance so as to detect the biological markers of different molecular subtypes of breast cancer. Methods We divided 100 breast cancer patients into four molecular subtypes by immunostaining: luminal subtype, HER-2(+) subtype, basal-like (BLs) subtype and normal breast-like (NBLs) subtype, and then compared the expression of MIF in the groups. We analyzed the associations of MIF-positive expression rate with age, menstruation, tumor size, auxiliary lymph node metastasis, histological type and grade, and clinical stage of the breast cancer patients. We also compared MVD level and 5-year overall survival rate between MIF-positive patients and MIF-negative ones. Results The positive expression of MIF was correlated with HER2(+) subtype breast cancer and auxiliary lymph node metastasis (P<0.05). The patients with MIF-positive expression had a significantly higher level of MVD than those with MIF-negative expression (P<0.05). Kaplan-Meier method showed that MIF-positive patients had a poor prognosis than MIF-negative ones (Log-rank=19.516, P=0.000). Conclusion Breast cancer patients with MIF-positive expression may be mostly of HER2 (+) subtype, and tend to develop auxiliary lymph node metastasis. These patients have a significantly higher level of MVD and poor prognosis than those with MIF-negative expression