CK56CK14雌激素受体和孕激素受体检测在乳腺导管内增生性病变辅助诊断中的应用  

Value of CK5/6, CK14, ER and PR detection in differential diagnosis of intraductal proliferative lesions of the breast

作　　者：牛凤婷[1] 王丽[1] 张巍[1] 吕淑华[1] 牛昀[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺病理科国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室乳腺癌防治教育部重点实验室,300060

出　　处：《中华肿瘤杂志》2015年第10期749-752,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金（81470119、81172532）

摘　　要：目的：探讨CK5／6、CK14、雌激素受体（ ER）和孕激素受体（ PR）表达模式在普通型导管上皮增生（UDH）、不典型导管上皮增生（ADH）和低级别导管原位癌（DCIS）辅助病理诊断中的意义。方法2013年1月至2014年2月天津医科大学肿瘤医院病理诊断为乳腺ADH、灶性早期癌变为低级别DCIS的连续病例20例，收集其相关临床病理资料，并进行CK5／6、CK14、ER和PR免疫组化检测。结果 CK5／6、CK14在UDH腺上皮细胞中阳性表达，呈镶嵌状，而在ADH和低级别DCIS的腺上皮细胞中则呈阴性表达。 CK5／6、CK14在UDH、ADH和低级别DCIS的肌上皮细胞均有阳性表达。ER、PR在UDH、ADH和低级别DCIS的腺上皮中均有阳性表达，在ADH和低级别DCIS中表现为弥漫、均匀一致的强阳性，而在UDH中表现为少数细胞异质性阳性。结论在乳腺导管内增生性病变中，联合检测CK5／6、CK14、ER和PR的表达，对UDH、ADH和低级别DCIS的辅助鉴别诊断有着切实可行的意义。Objective To investigate the expression of high？molecular？weight keratins CK5/6, CK14, estrogen receptor （ ER） and progesterone receptor （ PR） in differential diagnosis of simple ductal hyperplasia （ UDH） , atypical ductal hyperplasia （ ADH） and low？grade ductal carcinoma in situ （ low？grade DCIS） . Methods The clinicopathological data of twenty cases of atypical ductal epithelial hyperplasia （ ADH） with focal cancerization changed into low？grade DCIS diagnosed at Tianjin Medical University Cancer Institute and Hospital between January 2013 and February 2014 were reviewed and analyzed. The expressions of CK5/6, CK14, ER and PR were detected by immunohistochemistry. Results Positive expressions of CK5/6 and CK14 were seen in UDH showing a mosaic pattern, while negative expression in ADH and low？grade DCIS. In addition, CK5/6 and CK14 were positively expressed in the myoepithelial cells of UDH, ADH and low-grade DCIS. Positive expressions of ER and PR were observed in UDH, ADH and low？grade DCIS. But they presented diffuse and homogeneous strong positive expression in ADH and variable positive expression in UDH. Conclusion In the intraductal proliferative lesions of the breast, the use of combined detection of the expression of CK5/6, CK14, ER and PR is of practical significance in the differential diagnosis of UDH, ADH and low-grade DCIS.

关 键 词：乳腺肿瘤 普通型导管上皮增生 不典型导管上皮增生 低级别导管原位癌 CK5/6 CK14 雌激素受体 孕激素受体 

分 类 号：R737.9[医药卫生—肿瘤]