CK5/6在乳腺导管内增生性病变中的表达及意义  

Expression of CK5/6 in introductal proliferative lesions of breast

作　　者：陈定宝[1] 沈丹华[1] 虞有智[1] 王颖[1] 宋秋静[1] 阚秀[1] 

机构地区：[1]北京大学人民医院病理科,北京100044

出　　处：《诊断病理学杂志》2008年第5期386-389,共4页Chinese Journal of Diagnostic Pathology

基　　金：北京大学人民医院研究发展基金(P870)

摘　　要：目的探讨CK5/6在乳腺导管内增生性病变(IDPL)中的表达情况及鉴别诊断意义,讨论Boecker提出的乳腺干细胞理论的应用价值。方法根据WHO(2003)乳腺肿瘤分类标准对101例IDPL进行分类,大部分病例均含有1种以上病变。应用免疫组化进行CK5/6、CK18、SMA染色,观察其在不同类型病变及正常乳腺组织中的表达。结果观察普通性导管增生(UDH)74处、柱状细胞病变(CCL)74处、非典型性导管增生(ADH)49处及导管原位癌(DCIS)28处,共225处病灶;并观察33处正常乳腺组织。随着乳腺IDPL级别的增高,CK5/6的表达逐渐丢失,表达部位也不相同。在正常乳腺组织和UDH中,阳性细胞主要位于基膜侧和近腔缘侧,UDH腺腔中的阳性细胞排列呈弥漫性、拼花状或马赛克状;ADH阳性细胞主要位于基膜侧,腺腔内可见少量散在的阳性细胞;而低级别DCIS腺腔内阳性细胞则完全消失,CCL腺腔内也见不到阳性细胞。结论乳腺组织中存在着干细胞,CK5/6的表达部位、数目和方式的不同有助于乳腺IDPL的鉴别诊断。Objective To study the expression of CK5/6 and its value in differential diagnosis of introductal proliferative lesions of the breast, and to discuss the hypothetical progenitor （adult stem cell） concept proposed by Boecker. Methods 101 cases of intraductal proliferative lesion （IDPL） were selected and classified according to WHO histologic classification of breast ttanors （2003）, most of which had more than one lesion. The immunohistochemical staining of CK5/6, CK18 and SMA was performed in all IDPL and normal breast tissues. Results Totally 225 foci of usual ductal hyperplasia （UDH, 74 foci）, columnar cell lesion （CCL, 74 foci）, atypical ductal hyperplasia （ADH, 49 foci）, and ductal carcinoma in situ （DCIS, 28 foci） and 33 foci of normal breast tissue were observed. The expression of CK5/6 was lost as the grade of IDPL increasing. The sites of expression were also different. The positive cells were mainly luminal and basal in normal breast tissue and UDH, the patterns of which appeared diffuse or mosaic ; whereas in ADH they were basal ceils, only few of luminal cells were positive. None of pesitive cells were detected in luminal cells of low grade of DCIS, neither were CCL. Conclusions The stem cells do exist in the breast, whose differentiation and clonal pattern are different in different IDPL. The sites, number and pattern of CK5/6 immunostaining are useful for differential diagnosis of IDPL of the breast.

关 键 词：乳腺 导管内增生性病变 CK5/6 免疫组化 

分 类 号：R655.8[医药卫生—外科学]