乳腺导管内增生性病变的免疫细胞化学分析  

Analysis of immunocytochemistry of intraductal proliferative lesions of the breast

作　　者：冯鑫至[1] 林晓燕[2] 路红[3] 张凤霞[1] 梅红[1] 赵斌[1] 

机构地区：[1]山东省医学影像学研究所,山东济南250021 [2]山东省立医院病理科,山东济南250021 [3]泰山医学院附属莱钢医院,山东莱芜271126

出　　处：《医学影像学杂志》2014年第11期1907-1910,1926,共5页Journal of Medical Imaging

基　　金：2011年山东省科技发展计划项目(2011GGH21815);2011年山东省医药卫生科技发展计划项目(2011QW026)

摘　　要：目的评估不同的免疫表型在导管内增生性病变中的诊断与鉴别诊断中的意义。方法对177例乳头溢液患者在行乳腺导管镜检查后于异常管壁处行活检针定位搔刮,生理盐水冲洗,收集IDPL病例的乳腺导管冲洗液,得到了大量的新鲜细胞标本,采用免疫细胞化学方法分析其免疫表型特点。结果 Her-2、P53、Ki-67、CAM5.2在乳腺导管内病变,随着恶性程度的增加,其表达率逐级增加(P<0.05);CK5/6、P63在乳腺导管内病变各组中的表达亦随恶性程度的增加而降低(P<0.05)。结论乳腺导管冲洗液脱落细胞学诊断乳腺增生性病变较高的敏感性,免疫细胞化学法检测乳腺导管冲洗液脱落细胞的Her-2、P53、Ki-67和CAM5.2异常表达和CK5/6和P63的降低和消失发生在乳腺癌发生过程中的早期,联合检测可作为早期诊断癌前病变和估计预后的有效指标。Objective To assess the immunophenotypic characteristics of intraductal proliferative lesions and their clinical significance .Methods Immunocytochemistry was used to determinate the expression of Her‐2 ,P53 ,Ki‐67 ,CAM5 .2 , CK5/6 and P63 in 177 cases of women with nipple discharge who underwent FDS .Results Immunohistochemieal staining showed that CK5/6 and P63 were obviously expressed in glandular epithelial cells of ordinary‐type ductal hyperplasia , while they were lower or not expressed in atypical ductal hyperplasia ,fiat epithelial atypia and ductal carcinoma in situ . Her‐2 ,P53 ,Ki‐67 and CAM5 .2 were expressed more strongly than CK5/6 and P63 in ductal carcinoma in situ ,but were not expressed in ordinary‐type ductal hyperplasia .Conclusion The abnormal expression of Her‐2 ,P53 ,Ki‐67 ,CAM5 . 2 ,CK5/6 and P63 may be an early event in the progression of breast carcinoma ,and combined detection of them could be used for early diagnosis of breast cancer .

关 键 词：乳腺 导管内增生性病变 免疫细胞化学 

分 类 号：R583[医药卫生—内分泌] R446.6[医药卫生—内科学]