SOX10在乳腺导管上皮性病变病理诊断及鉴别诊断中的作用  

The role of SOX10 in the pathologic diagnosis and differential diagnosis of ductal epithelial lesions of the breast

作　　者：陈春妮 黄晓钟 王彩虹 杨军 CHEN Chunni;HUANG Xiaozhong;WANG Caihong;YANG Jun(Department of Pathology,the Second Affiliated Hospital of Xi'an Jiaotong University(Xibei Hospital),Shaanxi Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院(西北医院)病理科,陕西西安710004

出　　处：《现代肿瘤医学》2024年第7期1260-1264,共5页Journal of Modern Oncology

摘　　要：目的:探讨SOX10在乳腺导管上皮普通性增生(usual ductal hyperplasia,UDH)、非典型增生(atypical hyperplasia,ADH)、导管内癌(ductal carcinoma in situ,DCIS)及不同亚型浸润性导管癌中的表达情况。方法:收集我院病理科2021年12月至2023年06月进行了SOX10免疫组化染色的乳腺标本共197例,其中UDH 48例、ADH 20例、DCIS 40例、伴大汗腺分化的癌10例、luminal A 20例、luminal B 27例、Her2过表达10例及三阴性乳腺癌(triple-negative breast carcinoma,TNBC)22例,分析不同乳腺导管上皮性病变中SOX10的表达差异。结果:SOX10在48例UDH呈马赛克样斑驳着色,而20例ADH及40例DCIS中均不表达,差异具有统计学意义(P<0.001);SOX10在三阴性乳腺癌中阳性率为68.20%(15/22),而在luminal A型、luminal B型、Her2过表达型浸润性乳腺癌中均不表达,差异具有统计学意义(P<0.001);SOX10在AR阴性的三阴性乳腺癌中表达率高达86.67%(13/15),在AR阳性三阴型乳腺癌中仅有28.57%(2/7),而在伴大汗腺分化乳腺癌(AR均为阳性)中不表达,差异具有统计学意义(P<0.001);SOX10在所有正常乳腺导管周围肌上皮表达,而在32.5%(13/40)DCIS导管周围肌上皮缺失。结论:SOX10免疫组化染色是鉴别诊断UDH和ADH的特异性指标,但不能区分ADH和DCIS,且在导管内癌特别是高级别导管内癌肌上皮中可表达丢失,用来鉴别DCIS和浸润性癌特别是微浸润性乳腺癌有一定的风险;SOX10是三阴性乳腺癌相对特异的指标且与AR的表达呈负相关;正确判读SOX10的免疫组化染色模式,有利于我们更好的识别不同乳腺导管上皮性病变。Objective:To evaluate the expression of SOX10 in breast usual ductal hyperplasia(UDH),atypical hyperplasia(ADH),ductal carcinoma in situ(DCIS)and different subtypes of invasive ductal carcinoma.Methods:The expression of SOX10 in 197 cases of breast epithelial lesions(48 cases of UDH,20 cases of ADH,40 cases of DCIS,10 cases of apocrine carcinoma,20 cases of luminal A,27 cases of luminal B,10 cases of Her2 over-expression and 22 cases of triple-negative breast cancer it the second Affiliated Hospital of Xi'an Jiaotong University from December 2021to June 2023)was investigated by immunohistochemistry.Results:All UDH cases showed mosaic SOX10 expression,while all ADH and DCIS cases lacked expression(P<0.001).SOX10 expression was identified in 68.20% triple-negative breast carcinoma(TNBC)cases,while it was not expressed in luminal A,luminal B,Her2 overesperssiong invisive breast cancer(P<0.001).SOX10 was expressed in 86.67% of AR-TNBC,and only 28.75% of AR-TNBC,and was not expressed in apocrine carcinoma.The difference was statistically significant(P<0.001).SOX10 was expressed in all normal breast periductal myoepithelium,while it was absent in 32.5%(13/40)of DCIS periductal myoepithelium.Conclusion:SOX10 immunohistochemical staining is an important indicator to identify UDH and ADH,but it cannot distinguish ADH and DCIS,and it can be lost in the myoepithelium of intraductal carcinomas,especially high-grade intraductal carcinomas,so it is risky to use it to identify DCIS and invasive carcinomas,especially minimally invasive breast carcinomas.SOX10 is a relatively specific indicator of TNBC carcinomas,and it is negatively correlated with the expression of AR.The immunohistochemical staining pattern of SOX10 is correctly read,and is helpful for us to identify the different ductal epithelial lesions in the breast better.

关 键 词：SOX10 乳腺 普通型增生 非典型增生 三阴性乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]