乳腺肿瘤间质重构中间质成纤维细胞的免疫表型转换及其临床意义  

Changes of fibroblast immunophenotype and their clinical significance in stromal remodeling of breast tumors

作　　者：华兴[1] 黄笑笑[1] 廖泽晓 冼其[1] 于莉娜[2] 

机构地区：[1]暨南大学医学院第四附属医院广州市红十字会医院病理科,510220 [2]南方医科大学基础医学院病理学系

出　　处：《中华肿瘤杂志》2014年第11期834-838,共5页Chinese Journal of Oncology

基　　金：国家自然科学基金（81001111、81272849）;广东省科技计划项目（20128020700005）

摘　　要：目的 探讨在乳腺疾病谱系发展过程中间质成纤维细胞免疫表型的转化及其临床意义.方法 采用免疫组织化学方法分别检测60例正常乳腺、46例乳腺导管上皮细胞不典型增生（ADH）、60例乳腺导管内癌（DCIS）、47例乳腺导管内癌微浸润（DCIS-MI）和60例乳腺浸润性导管癌（IDC）组织中间质成纤维细胞成纤维细胞激活蛋白α（FAP-α）、α-平滑肌肌动蛋白（α-SMA）和CD34的表达.结果 正常乳腺组织中间质成纤维细胞的CD34、FAP-α和α-SMA阳性表达率分别为93.3％、6.7％和18.3％,ADH组织中间质成纤维细胞的CD34、FAP-α和α-SMA阳性表达率分别为95.7％、4.3％和10.9％,DCIS组织中间质成纤维细胞的CD34、FAP-α和α-SMA阳性表达率分别为95.0％、8.3％和15.0％,IDC组织中间质成纤维细胞的CD34、FAP-α和α-SMA阳性表达率分别为35.0％、85.0％和93.3％.正常乳腺、ADH和DCIS组织中间质成纤维细胞的CD34、α-SMA和FAP-α表达差异无统计学意义（x^2=1.142,P=0.896）,正常乳腺、ADH和DCIS组织的间质成纤维细胞免疫表型主要为CD34^＋ α-SMA^-FAP-α^-.IDC与正常乳腺、ADH和DCIS组织中间质成纤维细胞的CD34、α-SMA和FAP-α表达差异有统计学意义（x^2=8.351,P＜0.001）,IDC和DCIS-MI组织中间质成纤维细胞的免疫表型为CD34^-α-SMA^＋ FAP-α^＋.结论 间质成纤维细胞CD34表型的丢失及α-SMA和FAP-α表型的获得可能是DCIS-MI浸润前沿间质改变的一项敏感指标,检测DCIS间质成纤维细胞免疫表型的转化将有助于判断DCIS是否已有微浸润,提高DCIS-MI诊断的准确率.Objective To evaluate the immunophenotype conversion of fibroblasts and its clinical significance in the process of breast tumor stromal remodeling.Methods CD34,FAP-α,p63 and a-SMA were detected by immunohistochemistry in 273 breast biopsies,including 60 normal breast tissues,46 atypical ductal hyperplasia （ADH）,60 ductal carcinoma in situ （DCIS）,47 DCIS microinvasive carcinoma （DCIS-MI） and 60 invasive ductal carcinoma （IDC）.Results The positive expression rates of CD34,FAP-α and α-SMA in the stromal fibroblasts of normal breast tissues were 93.3%,6.7% and 18.3%,respectively.Those in the stromal fibroblasts of ADH tissues were 95.7%,4.3% and 10.9%,respectively.Those in the stromal fibroblasts of DCIS tissues were 95.0%,8.3% and 15.0%,respectively.Those in the IDC tissues were 35.0%,85.0% and 93.3%,respectively.The expressions of CD34,α-SMA and FAP-α in the stromal fibroblasts of normal,ASH and DCIS breast tissues did not show significant differences （x^2 =1.142,P =0.896）.The main immunophenotype of stromal fibroblasts in the tumor-host interface at the invasive front of ADH and DCIS lesions was CD34^＋α-SMA^＋ FAP-α^＋here were statistically significant differences in the expression of CD34,α-SMA and FAP-α between IDC and ADH,DCIS and normal breast tissues （x^2 =8.351,P 〈0.001）.The immunophenotype of stromal fibroblasts in the IDC and DCIS-MI breast tissues was CD34^-α-SMA^＋ FAP-α^＋onclusions Immunophenotype conversion from CD34^＋ α-SMA^-FAP-α^- CD34^-α-SMA^＋ FAP-α^＋ay be a sensitive indicator to judge whether DCIS has microinvasion.Detection of the immunophenotype conversion of stromal fibroblasts may be helpful to determine the presence of microinvasion,and to improve the diagnostic accuracy rate of DCIS.

关 键 词：乳腺肿瘤 肿瘤侵润 成纤维细胞 免疫表型分型 

分 类 号：R737.9[医药卫生—肿瘤]