细胞角蛋白34βE12在鉴别乳腺良、恶性病变中的意义  

The diagnostic value of 34βE12 in differential diagnosis of benign and malignant mammary lesions

作　　者：狄方[1] 王念黎[1] 

机构地区：[1]澳门镜湖医院病理科

出　　处：《中华病理学杂志》2004年第1期31-35,共5页Chinese Journal of Pathology

摘　　要：目的　探讨高分子量细胞角蛋白 3 4 βE12作为良性病变的标记物对鉴别乳腺病变的意义。方法　收集 90例有随访活检和组织病理学诊断对照的乳腺细针吸取细胞学 (FNAC)资料 :良性病变 50例 ,包括非增生性病变 3 0例和增生性病变 2 0例、导管内癌 10例和浸润癌 3 0例 ,对其FNAC涂片和相应的石蜡切片作 3 4 βE12的抗生物素蛋白 生物素 过氧化酶复合 (ABC)法免疫组织化学分析。利用SPSS10 .0软件进行统计学分析。结果　 (1) 3 4 βE12在良性非增生和增生性病变组中的表达差异无显著性。 (2 ) 3 4 βE12在良性病变和癌组中的表达差异具显著性 ,3 4 βE12在癌组中 ,FNAC涂片和相应的石蜡切片分别为 66.7%和 63 .3 %的病例表现为完全阴性或散在 1+的肿瘤细胞胞质阳性 ;在良性病变组中 ,FNAC涂片和相应的石蜡切片分别为 10 0 %和 78%的病例表现为 2 +至 3 +的细胞阳性 ,且在石蜡切片中 3 4 βE12表现为完整的细胞膜和细胞质的强阳性 ,与癌中阳性标本之细胞质颗粒状阳性为主的表达特点不同。 (3 ) 3 4 βE12在细胞分化较好的筛孔型、乳头型和实性型导管内癌中为完全阴性和散在细胞胞质阳性 ,而在细胞分化较差的粉刺型导管内癌中为阴性至 3 +的细胞阳性。结论　 3 4 βE12可作为乳腺病变鉴别诊断中良性病变的标?ObjectiveTo determine the differential diagnostic value of high molecular cytokeratin 34βE12 as a benign marker in mammary lesions. Methods90 cases (30 benign non-proliferative diseases, 20 benign proliferative diseases, 10 intraductal carcinomas and 30 invasive carcinomas) were collected, all of which had undergone fine needle aspiration cytology (FNAC) examination and a follow-up operation. Immunohistochemical staining was performed using monoclonal antibodies against 34βE12 on FNAC smears and the follow-up paraffin sections. SPSS 10.0 software was applied to analyze the differential diagnostic value of 34βE12 in benign and malignant mammary lesions. Results(1) No significant difference was found in the expression of 34βE12 between benign non-proliferative and prol iferative disease. (2) A significant difference was found between the expression of 34βE12 in mammary benign disease and mammary carcinoma. 66.7% and 66.3% of the carcinoma cases showed either lack of 34βE12 expression or had only a few isolated 1+ cells which were cytoplasmic positive for 34βE12 immunoreaction on FNAC smear and paraffin section respectively. The remaining 33% of cases having 2+ to 3+ cells mainly displayed cytoplasmic granular positive reaction rather than strong membranous and cytoplasmic positive reaction as benign lesions. In contrast with carcinoma, most benign lesions showed strong immunoreaction of 2+ to 3+ and especially exhibited complete strong membranous and cytoplasmic positive reaction on paraffin section,their positive expressive character differed from those of carcinoma. The positive rates on FNAC smear and paraffin section were 100% and 78% respectively. (3) Certain types of intraductal carcinoma, including low grade cribriform, papillary and solid type either lacked 34βE12 expression or revealed a few isolated 1+ cells with cytoplasmic positivity for 34βE12 immunoreaction. Pronounced immunoreaction of 3+ was only seen in high grade comedotype intraductal carcinoma. Conclusions34βE12 may serve as a marker o

关 键 词：细胞角蛋白34βE12 鉴别诊断 乳腺良恶性病变 细针吸取细胞学 免疫组织化学 

分 类 号：R446.8[医药卫生—诊断学]