乳腺癌伴神经内分泌分化与预后因素的相关性  

The correlation between breast carcinoma with neuroendocrine differentiation and the prognostic factors

作　　者：董春鸽 章杰 吴亮[2] 王蓉蓉[2] 陈国荣[2] 林曦 赵志 

机构地区：[1]温岭市第一人民医院病理科,浙江温岭317500 [2]温州医学院附属第一医院病理科,浙江温州325000

出　　处：《温州医学院学报》2011年第2期132-135,共4页Journal of Wenzhou Medical College

基　　金：温岭市科技计划资助项目(2009WLCB0058)

摘　　要：目的:通过观察雌激素受体(ER)、孕激素受体(PR)、Her-2、Ki67在乳腺癌伴神经内分泌分化(nueroendocrine differen-tiation,NED)中的表达,探讨乳腺癌伴NED的预后。方法:选取2000年1月至2009年8月温岭市第一人民医院乳腺癌根治术或改良根治术确诊病例55例,2008年8月-2009年8月温州医学院附属第一医院乳腺癌改良根治术确诊病例35例,根据CgA和Syn免疫组织化学染色结果,分为乳腺癌伴NED阳性和阴性两组。分析两组患者发病年龄、肿块大小、组织学分级、淋巴结转移状态、ER、PR、Her-2、Ki67的表达情况之间的差异。结果:90例患者中NED阳性组33例(占36.67%)。NED阳性组ER、PR阳性表达分别为24例(占72.73%)、21例(占63.64%),明显高于阴性组(P<0.05)。NED阳性组Her-2、Ki67阳性表达分别为11例(占33.33%)、15例(占45.45%),与NED阴性组比差异有统计学意义(P<0.05)。NED阳性组组织学分级为II～III级的患者比例为78.79%,低于NED阴性组92.98%(P<0.05)。NED阳性组淋巴结转移≥1枚的为7例(21.21%),明显低于NED阴性组24例(42.11%,P<0.05)。NED阳性组与NED阴性组间发病年龄及肿块大小的差异无统计学意义(P>0.05)。结论:与不伴NED的乳腺癌相比,乳腺癌伴NED的侵袭性较小,预后好。Objective： To study the expression of ER,PR,Her-2 and Ki67 in breast carcinoma with and without neuroendocrine differentiation（NED）.The prognosis of breast carcinoma with NED was estimated.Methods： Ninety breat cancer patients were surgically treated.55 cases of them came from our hospital.35 cases of them came from The First Affiliated Hospital of Wenzhou Medical College.The tumors with NED were detected with immunohistochemical staining of antibod-ies against CgA and Syn from 90 cases of infiltrative ductal carcinoma of the breast,and the 90 cases were divided into NE positive and NE negative groups.Finally,the differences between two groups were analyzed in age,tumor size,histological types and grading,lymph node metastasis,ER,PR,Her-2 and Ki67.Results： Among the 90 cases of infiltrative ductal carcinoma of the breast,33 cases（36.67%）of the tumors were of neuroendocrine differentiation and labeled as the NE positive group.In the NED positive group,24 cases（72.73%） were ER positive and 21 cases（63.64%） were PR positive.Thus,the differences between the two groups were significant（P 〈0.05）.In the NE positive group,11 cases（33.33%）were Her-2 positive,15 cases（45.45%）Ki67 positive.And the difference between the two groups was significant（P〈 0.05）.In the NED positive group,78.79% of the tumors was grade II-III（78.79% vs 92.98%,P 〈0.05）,and less lymph node metastases（21.21% vs 42.11%,P 〈0.05）.There was no significant difference between the two groups in the patient＇s age and the tumor size as well（P 〈0.05）.Conclusion： It is suggested that the prognosis of the breast carcinoma with NED is better than that of the breast carcinoma without NED.

关 键 词：乳腺肿瘤 神经内分泌分化 SYNAPTOPHYSIN CHROMOGRANIN A 雌激素受体 孕激素受体 原癌基因Her-2 细胞核增殖抗原Ki67 预后 

分 类 号：R737.9[医药卫生—肿瘤]