具有基底细胞样免疫表型的三阴性乳腺癌临床病理分析  

Clinicopathological Analysis of Triple-negative Breast Cancer with Basal Cell-like Phenotype

作　　者：张升瑞[1] 王星[2] 孙洁[2] 宦大为[2] 王翠芳[2] 

机构地区：[1]沈阳医学院奉天医院普外科,沈阳110024 [2]沈阳医学院奉天医院病理科,沈阳110024

出　　处：《中国医科大学学报》2012年第6期550-553,558,共5页Journal of China Medical University

基　　金：沈阳医学院科研基金资助项目(20111030)

摘　　要：目的分析三阴性乳腺癌中基底细胞样免疫表型的表达情况,探讨具有或不具有基底细胞样免疫表型的三阴性乳腺癌在临床病理特征和Ki67、P53表达等方面的差异。方法用免疫组化方法观察42例三阴性乳腺浸润癌中CK5/6、CK14、EGFR、Ki67及P53蛋白的表达,研究该组乳腺癌中表达基底细胞样免疫表型与临床病理特征和Ki67、P53表达的关系。结果 24例（57.1%）表达CK5/6、CK14、EGFR中1项或几项标志物,具有基底细胞样免疫表型,其中CK14没有单独表达;18例（42.9%）均不表达CK5/6、CK14、EGFR。24例表达基底细胞样免疫表型的乳腺癌中癌细胞核级别Ⅲ级22例,Ⅱ级2例,且有相似的形态学特征,24例中有Ki67表达22例;18例不表达基底细胞样免疫表型的乳腺癌中癌细胞核级别Ⅲ级3例,Ⅰ~Ⅱ级15例,18例中有Ki67表达8例。具有与不具有基底细胞样免疫表型的三阴性乳腺癌比较,核级别及Ki67表达均有统计学差异（P〈0.01）。结论具有基底细胞样免疫表型的三阴性乳腺癌是一种具有独特形态学特征及免疫表型的乳腺癌。临床工作中依靠特征性形态学改变及使用免疫组化方法标记CK5/6、EGFR及Ki67,对诊断该类病变和判断预后有实际应用意义。Objective To detect the expression of triple-negative breast cancers （TNBCs） with the basal cell-hke phenotype,to explore whether TNBCs have the basal cell-hke phenotype,and to study the clinicopathological features and Ki67 ,p53 expressions differences between basal cell-like and non-basal cell-like TNBCs. Methods hnmunohistochemical staining was used to detect the protein expressions of CK5/6, CKI4, EGFR, Ki67 and P53 in 42 cases of triple-negative breast invasive carcinoma. We studied the relationship among the expression of basal cell-like phenotype,clinicopathological features and the expressions of Ki67 and P53. Results Twenty four cases expressed one or several basal cell-like phenotype markers （CKS/6,CKI4,EGFR）,accounting for 57.1% of the 42 triple negative breast patients,while CKI4 was not solely expressed. Eighteen cases （42.9%） did not express CKS/6,CK14 or EGFR. Twenty four TNBCs with basal cell-like phenotype had similar morphological characteristic and nuclear levels,including grade III （22 cases） and grade II （2 cases ）. And Ki67 was expressed in 22 out of 24 cases. The breast cancer cells nuclear levels of 18 non-basal cell-like cases showed grade II （3 cases） and grade I （15 cases）,grade I] （15 cases）,and Ki67 was expressed in 8 out of 18 cases. The difference in nuclear level and Ki67 expression between basal-like and non-basal-like TNBCs was statistically significant （P 〈 0.01 ）. Conclusion Basal cell-like phenotype of TNBCs is a breast cancer with a unique phenotype and morphological characteristics. Characteristic morphological changes and clinical use of CK5/6, EGFR and Ki67 marked by immunohistochemical staining had practical significance in the diagnosis and prognosis of such lesions.

关 键 词：三阴性乳腺癌 基底细胞样免疫表型 临床病理 预后指标 

分 类 号：R737.9[医药卫生—肿瘤]