钙化型及非钙化型乳腺导管原位癌的病理分级及免疫组织化学特征  

Histopathological and Immunohistochemical Features of Calcified and Non-calcified DCIS of Breast Ductal Carcinoma in Situ

作　　者：段克举 杨亚芳 刘真真 DUAN Keju;YANG Yafang;LIU Zhenzhen(Department of Breast,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou,Henan Province 450000,P.R.China)

机构地区：[1]郑州大学附属肿瘤医院乳腺科,450000

出　　处：《临床放射学杂志》2021年第1期42-47,共6页Journal of Clinical Radiology

摘　　要：目的比较X线表现为钙化型和非钙化型乳腺导管原位癌(DCIS)的病理分级和免疫组织化学特征的区别。方法回顾性分析经手术证实为DCIS的121例患者(124个病灶),根据术前X线表现分为钙化组和非钙化组,分析两组间病理分级及雌激素受体(ER)、人表皮生长因子受体2(HER2)表达情况的区别,并对钙化组病灶分析其钙化特点与病理及免疫组织化学的相关性。结果钙化型和非钙化型DCIS的病理特点和ER、HER2表达情况均有统计学差异。钙化型中以高级别伴有微浸润的DCIS为主(35/90,38.9%),且HER2阳性型(ER阴性)居多(48/90,53.3%),非钙化型以单纯型非高级别DCIS为主(14/34,41.2%),且ER阳性型(HER2任意)居多(24/34,70.6%)。另外,钙化型DCIS的免疫组织化学特征与钙化形态和分布都相关,病理分级只与钙化形态相关。结论 DCIS的X线表现可以一定程度上反映其病理特点和免疫组织化学特征,从而间接提示预后情况。Objective To explore the differences in histopathology and immunohistochemistry between calcified and non-calcified ductal carcinoma in situ of breast detected by mammography. Methods All the 124 lesions were divided into calcified and non-calcified DCIS according to the presence of calcifications on mammography.Pathologicgradeandtheexpression of estrogen receptor and human epidermal growth factor receptor 2 were compared between two the groups. The correlation between microcalcification characteristics and histopathologic and immunohistochemical features were analyzed. Results There were significant differences in histopathology and immunohistochemistry between calcified and non-calcifiedDCISdetected by mammography.Calcified DCIS were more likely to be high grade with microinvasion(35/90,38.9%)and most of them belonged to HER2-positive group(48/90,53.3%).Non-calcified lesions were more likely to be pure DCIS with non-high grade(14/34,41.2%)and more frequently observed as ER-positive type(24/34,70.6%).In addition, both the morphology and distribution of calcifications were related to immunohistochemical features of the calcified group. However, pathologic grade was only determined by the distribution of calcification. Conclusion The mammographic appearance of DCIS can to some extent reflect the pathologic grade and the expression of ER,HER2, whichmay predict the biological behavior and prognosis of DCIS.

关 键 词：乳腺癌 导管原位癌 乳线X线摄影 病理学 免疫组织化学 

分 类 号：R737.9[医药卫生—肿瘤]