免疫组织化学多抗体双染技术在乳腺微浸润癌病理诊断中的应用  

Application of immunohistochemical multi-antibody double staining technique in the pathological diagnosis of microinvasive breast cancer

作　　者：张姗 管毓翔 昂琳 王瑾 郑丽 苏明琴 陈利杰 赵敏 Zhang Shan;Guan Yuxiang;Ang Lin;Wang Jin;Zheng Li;Su Mingqin;Chen Lijie;Zhao Min(Department of Pathology,Hefei Hospital Affiliated to Anhui Medical University/Second People′s Hospital of Hefei,Anhui 230011,China)

机构地区：[1]安徽医科大学附属合肥医院/合肥市第二人民医院病理科,合肥230011

出　　处：《中华转移性肿瘤杂志》2024年第6期561-565,共5页Chinese Journal of Metastatic Cancer

基　　金：合肥市卫生健康委2023年应用医学科研项目(Hwk2023zd007)。

摘　　要：目的探讨免疫组织化学(IHC)多抗体双染技术在乳腺微浸润癌病理诊断中的应用。方法将肌上皮标志物(Calponin/p16)和上皮标志物(E-cadherin/CK7)进行单抗体、双抗体及三抗体共8种组合,对2016—2019年合肥市第二人民医院病理科的100例非肿瘤乳腺病例进行检测,选出最佳抗体组合。将该组合及最优流程引入IHC染色机,对2020—2023年该病理科经HE结合IHC单染初诊为乳腺导管原位癌(40例)伴可疑浸润(26例)及微浸润癌(17例)共83例进行检测,评估肌上皮及腺上皮的染色强度和比例。统计分析乳腺微浸润癌的确诊率、可疑微浸润的报告率。结果Calponin/p16+E-cadherin为最佳抗体组合。初诊为乳腺微浸润癌的病例均证实为明确浸润;导管原位癌中9例证实伴微浸润;可疑浸润病例中7例证实为微浸润癌,10例原位癌。乳腺微浸润癌的确诊率由20.5%提升至39.8%,可疑浸润的报告率由31.3%下降至10.8%。结论三抗体双染法可以更清晰、准确地显示浸润成分,显著提高乳腺微浸润癌的确诊率,降低可疑浸润的报告率,对病理诊断及临床治疗有重要意义。Objective To investigate the application of immunohistochemical(IHC)multi-antibody double staining technique in the pathological diagnosis of microinvasive breast cancer.Methods The myoepithelial cell marker(Calponin/p16)and epithelial cell marker(E-cadherin/CK7)were used for 8 combinations of single,double and triple antibodies.A total of 100 cases of non-neoplastic breast tissue archived in the pathology department of Second People′s Hospital of Hefei from 2016 to 2019 were detected,and the best antibody combination was screened.This combination and optimal process programming were introduced into the automatic IHC staining machine.A total of 83 patients including those with breast ductal carcinoma in situ(40 cases)or with suspected infiltration(26 cases)and the microinvasive breast cancer(17 cases),which were diagnosed by HE staining combined with IHC monostaining in pathology department of this hospital from 2020 to 2023,were further detected.The staining intensity and proportion of myoepithelial cells and glandular epithelial cells were evaluated,respectively.The diagnosis rate of microinvasive breast cancer and the reporting rate of suspicious microinvasive breast cancer were statistically analyzed.Results The combination of Calponin/p16 and E-cadherin was selected as the optimal antibody combination.All of the cases with microinvasive breast cancer diagnosed initially were confirmed to be definite invasive cancer;In initially-diagnosed ductal carcinoma in situ of the breast,9 cases were confirmed to have associated microinvasion;In initially-diagnosed suspicious infiltration,7 cases were confirmed to be microinvasive cancer,and 10 cases were carcinoma in situ.The definitive diagnosis rate of microinvasive breast cancer increased from 20.5%to 39.8%,while the reporting rate of suspicious microinvasion decreased from 31.3%to 10.8%.Conclusions The triple antibody double-staining method can more clearly and accurately label the components of invasion,significantly improve the diagnosis rate of microinvasive b

关 键 词：乳腺癌 微浸润 免疫组织化学多色染色技术 病理诊断 确诊率 

分 类 号：R73[医药卫生—肿瘤]