克隆性分析在乳腺导管内增生性病变预后评估中的应用  

The progression of intraductal proliferative lesions of the breast by clonal assay

作　　者：陈妹琼[1] 张鋆歆[1] 彭凌[1] 

机构地区：[1]中国人民解放军第305医院,100017

出　　处：《山西医药杂志（下半月）》2013年第11期1214-1216,共3页Shanxi Medical Journal

基　　金：首都医学发展科研基金(2009-3063)

摘　　要：目的探讨各级导管内增生性病变的克隆组成,以判断病变是否为肿瘤性增生。方法选取80例女性导管内增生性病变,包括普通导管增生(UDH)20例,平坦型上皮非典型增生(FEA)15例,非典型导管增生(ADH)20例,导管内原位癌(DCIS)25例,另外选取20份正常乳腺组织作为对照,应用显微切割技术分离所需病变,提取基因组DNA,经甲基化敏感的HhaⅠ消化,巢式聚合酶链反应(PCR)扩增雄激素受体(AR)基因,应用变性聚丙烯酰胺凝胶电泳显示AR基因的CAG重复序列长度多态性。结果 100例标本中91例扩增成功;所有的DCIS均为单克隆性增生,所有正常组织和大多数的UDH(94%,17/18)为多克隆性增生,27%(3/11)的FEA及71%(12/17)的ADH为单克隆性增生。结论大部分的ADH及部分FEA,所有的DCIS为单克隆性增生,为肿瘤性增生。Objective To demonstrate the elonallty status of intraduetal proliferative lesions. Methods Four groups＇ samples, including 20 cases of usual ductal hyperplasia （UDH）, 15 cases of flat epithelia atypia （FEA）, 20 cases of atypical ductal hyperplasia （ADH）, and 25 cases of ductal carcinoma in situ （DCIS） were selected for analysis. Twenty specimens of normal breast tissue were used as a control group. Microdissection was performed to collect the tissue samples for extraction of genomic DNA from paraffin-embedded tissues. The DNA was subjec- ted to nested PCR amplification of the CAG- repeats in androgen receptor （AR） gene exon I with and without pri- or digestion of methylation-sensitive restriction enzyme Hha I. Gel electrophoresis was used to detect the clonal nature of these four groups＇ samples. Results DNA from 91 of 101 patients was able to be amplified at the AR gene exon I ~ The analysis confirmed monoclonality in all informative samples of DCIS ceils. Normal tissues and the majority （94~） of UDH were shown to be polyclonal. Monoclonality was revealed in 12/17 （71G） cases of ADH. Among 11 cases of FEA, 8 cases were shown to be polyclonal, while 3 cases displayed monoclonal altera tions which accounted for 27~/oo. Conclusion Most of ADH, the smaller part of FEA and all I）CIS have clonal al- terations, which may be neoplastic lesions.

关 键 词：乳腺疾病 克隆 分子 聚合酶链反应 

分 类 号：R737.9[医药卫生—肿瘤]