DCIS、DCIS-MI、DCIS-IDC及IDC的分子分型差异性研究  

Research molecular typing differences of DCIS,DCIS-MI,DCIS-IDC and IDC

作　　者：曾益辉 黄思敏 唐大为 李鸿恩 李成威 梅世伟[1] ZENG Yihui;HUANG Simin;TANG Dawei;LI Hongen;LI Chengwei;MEI Shiwei(Department of Radiology,Guangdong Province Hospital for Women and Children Healthcare,Guangdong Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院放射科,广东广州511400

出　　处：《现代肿瘤医学》2025年第1期60-67,共8页Journal of Modern Oncology

摘　　要：目的:探讨乳腺导管原位癌(ductal carcinoma in situ of the breast,DCIS)、导管原位癌伴微浸润(ductal carcinoma in situ with microinvasion,DCIS-MI)、乳腺导管原位癌伴浸润性导管癌(ductal carcinoma in situ with invasive ductal cancer,DCIS-IDC)与浸润性导管癌(invasive ductal cancer,IDC)的分子分型差异。方法:回顾性分析本院2012年01月至2022年11月经术后病理证实的乳腺癌2048例患者资料,记录四组患者免疫组化标记物[雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体(human epidermal growth factor receptor-2,Her-2)、肿瘤细胞增殖活性标志物(Ki-67)]、分子分型及核异型性的情况,采用χ2检验或Fisher确切概率法比较四组患者免疫组化标记物、分子分型及核异型性差异性。结果:2048例乳腺癌患者,其中DCIS组为181例,DCIS-MI组为69例,DCIS-IDC组为702例,IDC组为1096例。免疫组织化学标记物方面:DCIS、DCIS-MI、DCIS-IDC及IDC患者在ER、PR、Her-2、Ki-67中的阳性分布差异均有显著统计学意义(P均<0.001);ER、PR阳性DCIS-MI组明显低于DCIS组、DCIS-IDC组及IDC组,Her-2阳性DCIS-MI组明显高于DCIS组、DCIS-IDC组及IDC组,Ki-67高表达DCIS组明显低于DCIS-MI组、DCIS-IDC组及IDC组,差异均有显著统计学意义(P均<0.001)。分子分型方面:DCIS-MI组以Her-2过表达型较常见(55.1%);DCIS-IDC及IDC组以Luminal B型为主,分别为52.7%、56.7%;DCIS组以Her-2过表达型、Luminal A型、Luminal B型平均分布多见,分别为32.6%、32.0%、31.5%,四组数据在分子分型上总体有显著差异,具有统计学意义(P<0.001)。DCIS、DCIS-MI、DCIS-IDC、IDC组间两两比较,差异均具有统计学意义(P均<0.05)。核异型性方面:DCIS、DCIS-MI及DCIS-IDC患者在核异型性上差异具有显著统计学意义(P<0.001)。结论:DCIS-MI免疫组化标记物及分子分型较DCIS、DCIS-IDC、IDC差异明显,是不同于DCIS的乳腺癌组分。Objective:To investigate the differences in molecular staging of ductal carcinoma in situ of the breast(DCIS),ductal carcinoma in situ with microinvasion(DCIS-MI),ductal carcinoma in situ with invasive ductal cancer(DCIS-IDC)and invasive ductal cancer(IDC).Methods:We retrospectively analyzed the data of 2048 patients with postoperative pathologically confirmed breast cancer in the hospital from January 2012 to November 2022,and recorded the immunohistochemical markers[estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(Her-2),and markers of proliferative activity of tumor cells(Ki-67)],molecular typing,and nuclear heterozygosity of the patients in four groups,and compared the differences of immunohistochemical markers,molecular typing,and nuclear heterozygosity among patients of the four groups with the use of theχ2 test or Fisher's exact probability method.Results:2048 breast cancer patients,of which 181 were in the DCIS group,69 in the DCIS-MI group,702 in the DCIS-IDC group and 1096 in the IDC group.As for immunohistochemical markers:The differences in the distribution of positivity in ER,PR,Her-2,and Ki-67 among DCIS,DCIS-MI,DCIS-IDC,and IDC patients were all statistically significant(all P<0.001).The ER-and PR-positive DCIS-MI group were significantly lower than the DCIS group,the DCIS-IDC group,and the IDC group,and the Her-2 positive DCIS-MI group were significantly higher than DCIS group,DCIS-IDC group and IDC group,and Ki-67 high-expression DCIS group were significantly lower than DCIS-MI group,DCIS-IDC group and IDC group,and the differences were all statistically significant(P<0.001).In terms of molecular typing:Her-2 overexpression type was more common in the DCIS-MI group 55.1%,Luminal B type was predominant in the DCIS-IDC and IDC groups,52.7%and 56.7%,respectively,and the average distribution of Her-2 overexpression type,Luminal A type,and Luminal B type were more common in the DCIS group,32.6%,32.0%,and 31.5%,and there was a statistically significant overall d

关 键 词：导管原位癌 导管原位癌伴微浸润 浸润性导管癌 分子分型 

分 类 号：R737.9[医药卫生—肿瘤]