乳腺间质CD34和平滑肌肌动蛋白免疫组化检测在乳腺癌诊断中应用  

Immunohistochemical detection of stromal CD34 and smooth muscle actin in breast cancer diagnosis

作　　者：邬万新[1] 张燕萍[1] 钱建育[1] 唐正英[1] 温晓伟[1] 陆宁[1] 

机构地区：[1]嘉兴学院附属第一医院病理科,浙江嘉兴314000

出　　处：《中国癌症杂志》2004年第6期513-516,共4页China Oncology

摘　　要：目的 :评价免疫组化检测乳腺间质纤维细胞CD34和平滑肌肌动蛋白 (SMA)表达在乳腺癌诊断中价值。方法 :6 7例乳腺活检组织进行CD34和SMA免疫组化检测 ,其中乳腺癌 4 2例 ,乳腺良性病变 2 5例。观察各类乳腺病变间质的CD34和SMA表达状况 ,并分析CD34和SMA表达的相关性。结果 :2 5例良性病变中CD34表达 10 0 % (2 5 / 2 5 ) ,SMA表达 4 8% (12 / 2 5 )。 34例浸润性乳腺癌 (不包括 8例单纯导管内癌 )CD34全部缺乏表达 (0 /34) ,SMA表达 10 0 % (34/ 34)。CD34和SMA表达在乳腺浸润性癌和乳腺良性病变中表达的差异均具有显著性 (P<0 .0 1和P <0 .0 1)。导管内癌 (单纯导管内癌 8例和伴有浸润性癌的导管内癌成分 13例 )导管周围间质的纤维细胞CD34和SMA表达不均一 ,呈现为不同程度丢失CD34表达和获得SMA表达 ,并且CD34和SMA的表达呈负相关 (r= 0 .931,P <0 .0 1)。结论 :本研究结果表明乳腺间质纤维细胞CD34表达缺乏是浸润性乳腺癌间质改变的一项敏感指标。导管内癌管周间质的纤维细胞CD34和SMA表达不均一体现了从原位癌向浸润性癌发展的过程 ,因此 ,导管内癌管周间质丢失CD34+ 纤维细胞同时出现SMA+ 肌纤维母细胞反应可能是癌细胞向间质浸润的前兆。Purpose:To evaluate the value of immunohistoc he mical detection of mammary stromal fibrocyte CD34 and smooth muscle actin (SMA) expressions in breast cancer diagnosis. Methods:CD34 and SMA were detected immunohistochemically in 67 breast biopsies which included 42 breast cancers (infiltrative ductal carcinoma 30, infiltrative lobular carcinoma 2, mucous carcinoma 2, ductal carcinoma in situ 8) and 25 breast benign lesions (breast adenosis 10, sclerosal adenosis 5 , fibroadenoma 10). The expressions of CD34 and SMA were observed in these lesio ns, and the correlation of CD34 and SMA was analyzed. Results:CD34 was detected in all 25 benign lesions (25/25) and SMA in 48% (12/25) of cases.No expression of CD34 in all 34 infiltrative carcin omas (0/34) while SMA was expressed in all cases (34/34). The differences of CD3 4 and SMA expressions between infiltrative carcinoma and benign lesion were sign ificant, respectively(P<0.01 and P< 0.01). The expressions of CD34 and SMA in the stromal fibrocytes surrounding ductal carcinoma in situ (DCIS ) (including pure DCIS and DCIS with infiltrative carcinoma) were heterogeneous. The fibrocytes surrounding ducts of DCIS lost CD34 expression in varying degree s and gained SMA expression. Meanwhile, negative correlation was found between C D34 expression and SMA expression in DCIS (r= -0.931, P<0.01). Conclusions:Losts of CD34 expression in breast stromal fibrocyt es is a sensitive index of stromal change of breast infiltrative carcinoma. The heterogeneous expressions of CD34 and SMA in stromal fibrocytes surrounding DCIS exhibit the transition from carcinoma in situ to infiltrative carcinoma. Theref ore, when breast stroma loses its CD34 +fibrocytes and displays reaction of SMA + myofibroblasts in DCIS may be a forewarning for cancer cells to infi ltrate stroma.

关 键 词：乳腺肿瘤 导管内癌 间质 纤维细胞 CD34 平滑肌肌动蛋白 

分 类 号：R737.9[医药卫生—肿瘤] R730.45[医药卫生—临床医学]