超声引导下粗针穿刺活检标本p53、PD-L1检测在乳腺癌中的应用价值  

The application value of p53 and PD-L1 detection in ultrasound-guided core needle biopsy specimens in breast cancer

作　　者：翟晓利[1] 章艳斐[1] 王利霞[1] Zhai Xiaoli;Zhang Yanfei;Wang Lixia(Department of Pathology,Jinhua Central Hospital,Jinhua 321000,China)

机构地区：[1]金华市中心医院病理科,金华321000

出　　处：《中华内分泌外科杂志》2023年第3期348-352,共5页Chinese Journal of Endocrine Surgery

基　　金：金华市科技计划项目(2022-3-073)。

摘　　要：目的探讨乳腺癌超声引导下粗针穿刺活检标本中p53、PD-L1的表达情况,并分析其应用价值。方法选择金华市中心医院2021年8月至2022年9月收治的98例行超声引导下粗针穿刺活检及根治性手术的患者作为研究对象,收集患者临床资料,借助免疫组化实验检测穿刺活检标本和根治性手术切除标本中p53、PD-L1的表达情况并分析一致性。统计学检验分析p53、PD-L1表达与患者病理参数的关系。结果 98例患者中,粗针穿刺标本p53的阳性率为48.0%,PD-L1的阳性率为55.1%,根治性手术标本p53的阳性率为62.2%,PD-L1的阳性率为61.2%,粗针穿刺标本与根治性手术标本的一致率p53为63.6%(κ=0.441,P<0.001),PD-L1为65.3%(κ=0.505,P<0.001)。以根治性手术标本的结果为准,粗针穿刺标本中p53、PD-L1阳性表达的病例,在根治性手术标本中均呈阳性,特异度均为100%。有25例粗针穿刺活检的标本中p53被判定为阴性,但根治性手术标本中p53为阳性,粗针穿刺假阴性率为49.0%。有20例粗针穿刺活检的标本中PD-L1被判定为阴性,但根治性手术标本为阳性,粗针穿刺假阴性率为41.7%。p53、PD-L1表达的一致率与穿刺条数、穿刺条长度、浸润性癌长度及浸润性癌的占比均无显著相关性(均P>0.05)。粗针穿刺标本中p53、PD-L1表达与肿瘤大小、pTNM分期、Ki67情况的差异有统计学意义(均P<0.05),与患者年龄、BMI、家族史、组织学类型、Nottingham组织学分级情况无显著相关性(均P>0.05)。结论乳腺癌超声引导下粗针穿刺活检标本与根治性手术切除标本中p53、PD-L1表达的一致率分别为63.6%、65.3%,阳性检测结果特异度均为100%,对乳腺癌的临床治疗有一定指导意义。Objective The aim of this study is to investigate the expression of p53 and PD-L1 in ultrasound-guided core needle biopsy specimens of breast cancer,and to analyze their application value.Methods Ninety-eight patients who underwent ultrasound-guided coarse needle puncture biopsy and radical operation admitted to our hospital from Aug.2021 to Sep.2022 were selected as the study objects.The clinical data of patients were collected,the expression of p53 and PD-L1 in puncture biopsy specimens and radical surgical excision specimens were detected by immunohistochemical experiment,and the consistency was analyzed.Statistical test was used to analyze the relationship between the expression of p53 and PD-L1 and the pathological parameters of patients.Results In 98 patients,the positive rate of p53 and PD-L1 in core needle biopsy specimens was 48.0%and 55.1%,respectively.The positive rate of p53 and PD-L1 in radical operative specimens was 62.2%and 61.2%,respectively.The concordance rates of p53 and PD-L1 were 63.6%(κ=0.441,P<0.001)and 65.3%(κ=0.505,P<0.001)between core needle biopsy specimens and radical operative specimens.Taking the results of radical operative specimens as the standard,the cases with positive expression of p53 and PD-L1 in core needle biopsy specimens were all positive in radical operative specimens,and the specificity was 100%.p53 was determined negative in 25 coarse needle biopsy specimens,however,p53 was positive in radical surgical specimens,and the false negative rate of coarse needle puncture was 49.0%.PD-L1 was determined negative in 20 coarse needle biopsy specimens,but it was determined positive in radical operative specimens,and the false negative rate of coarse needle puncture was 41.7%.There was no significant correlation between the consistency rate of p53 and PD-L1 expression and the number of puncture cores,the length of puncture cores,the length of invasive carcinoma and the proportion of invasive carcinoma(all P>0.05).The expressions of p53 and PD-L1 in core needle biopsy specimens

关 键 词：粗针穿刺活检 P53 PD-L1 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]