目的：探讨人表皮生长因子受体2（humman epidermal growth factor receptor 2，HER2）阳性乳腺癌组织中主要组织相容性复合体-I 类链相关蛋白A和B(MHC class I chain-related protein A/B，MICA/B)的表达水平与患者无病生存期（disease-free survival，DFS）的关系。方法：收集南方医科大学郑州人民医院2009 年1 月至2010 年6 月HER2 阳性乳腺癌癌旁组织存档蜡块26 例及乳腺癌蜡块100 例，免疫组化染色检测癌旁组织及癌组织MICA/B的表达水平，采用Kaplan-Meier 生存曲线分析其与患者临床病理特征和DFS的关系。结果：MICA/B在癌旁组织中呈阴性(0/26)；乳腺癌组织中MICA/B表达率为92%（92/100），其中高表达为65%（65/100）；MICA/B 在Ⅰ期的高表达率高于Ⅱ~Ⅲ期（77.55% vs 52.94%，P<0.05)，在T1 期的高表达率高于T2~T4 期（75.00% vs 52.27%，P<0.05）；ER、PR 阳性（阳性细胞数≥1%）组MICA/B 高表达率显著低于ER、PR 阴性组（ER：52.38% vs 74.14%；PR：51.35% vs 73.02%，均P<0.05）。MICA/B的表达与患者的临床分期、ER、PR的表达及肿瘤大小有关（均P<0.05），与绝经状态、组织学分级及淋巴结转移无关（均P>0.05）。无论靶向治疗组（90.6% vs 72.2%，P<0.05）或非靶向治疗组（78.4% vs 58.8%，P<0.05）MICA/B高表达组6 年DFS均显著高于低表达组。结论：HER2 阳性乳腺癌组织中MICA/B高表达与患者的DFS密切相关，可作为患者预后的潜在预测指标。

Objective: To investigate the relationship between expression of MICA/B (MHC class I chain-related protein A/B) and disease-free survival (DFS) of patients with HER2+ (human epidermal growth factor receptor 2) breast cancer tissue. Methods: Twenty six cases of corresponding para-cancerous tissue and 100 cases of HER2+ breast cancer tissue that preserved in wax at Zhengzhou People’s Hospital Affiliated to Southern Medical University from January 2009 to June 2010 were collected for this study. Expression of MICA/B in these tissue samples was detected by immunohistochemistry; and the relationship between MICA/B expression with clinicopathologic features as well as DFS was analyzed with Kaplan-Meier survival curve. Results: The expression of MICA/B in adjacent paracancerous tissues was negative (0/26), however, it was highly positive in cancer tissues (92/100), and the percentage with high expression was 65%(65/100), the difference was significant (P<0.05). High MICA/B expression rate in stage I was significantly higher than that in stage Ⅱ-Ⅲ (77.55% vs 52.94%，P<0.05), and the high expression rate in stage T1 was also significantly higher than that in stage T2-T4 (75.00% vs 52.27%，P<0.05). High MICA/B expression rate in ER+, PR+ group (with positive number ≥1%) was significantly lower than that in ER- , PR- group (ER：52.38% vs 74.14%，PR：51.35% vs 73.02%，all P<0.05). MICA/B expression was correlated with clinical stages, the expression of ER, PR and tumor size (all P<0.05), but not associated with menopausal status, histological grade and lymph node metastasis (all P>0.05). Over-expression of MICA/B was closely associated with much better 6-year DFS rate in patients no matter with or without targeted therapy (the targeted group: 90.6% vs 72.2%; the untargeted group: 78.4% vs 58.8%, all P<0.05). Conclusion: Over-expression of MICA/B in HER2+ breast cancer tissue is closely related to DFS, which may be served as a potential prognosis indicator for patients with HER2+ breast cancer.

郑州市科技局普通资助项目（郑科技[2014] 2 号）