血清CA153、CEA和TPA联检在术前乳腺肿瘤鉴别诊断中的价值

目的:本文探讨血清CA153、CEA和TPA联检在术前乳腺肿瘤鉴别诊断中价值,以期为乳腺癌患者即时手术提供帮助.方法:采用放射免疫分析,检测乳腺肿瘤患者和健康人群血清CA153、CEA和TPA含量.结果:在CA153、CEA和TPA血清学检测中,术前乳腺癌组与乳腺良性肿瘤和健康人群组表达水平存在明显差异.术前乳腺癌组阳性率:CA153为63.8%,CEA为22.4%,TPA为62.1%;术前乳腺癌组联检阳性率:CA153和CEA为69.8%,CA153和TPA为87.1%,三者联检为90.5%;术前乳腺癌组检测特异性:CA153为77.9%,CA153和CEA联检为77.9%,CA153和TPA联检为71.9%,三者联检为73.4%.结论:当CA153、CEA和TPA三者联检时,术前乳腺癌组诊断阳性率显著提高,阳性组特异性无明显下降,值得临床推广应用.     

新疆地区维吾尔族乳腺癌BRCA1基因突变分析

目的研究新疆地区维吾尔族乳腺癌患者BRCA1基因突变情况及突变位置。方法选取70例维吾尔族乳腺癌根治标本,对照组为32例维汉族乳腺良性病变（纤维腺病及纤维腺瘤）及乳腺癌旁非癌组织;应用PCR-单链构象多态性和DNA序列测定的方法检测BRCA1基因突变。结果（1）70例维吾尔族乳腺癌中发现9例BRCA1突变的12个新位点。（2）70例维吾尔族乳腺癌BRCA1的突变率为12.86%（9/70）,22例维吾尔族早发性乳腺癌（≤35岁）BRCA1突变率为31.82%（7/22）。维吾尔族早发性乳腺癌BRCA1突变率（7/22）高于维吾尔族晚发性乳腺癌（2/48）,差异有统计学意义（χ^2=10.295,P〈0.01）。（3）70例维吾尔族乳腺癌中发现9例BRCA1基因核苷酸多态性位点,其中8例多态性位点均为3232A〉G。（4）2例双侧乳腺癌中均检测出BRCA1基因的突变。结论BRCA1突变可能与新疆维吾尔族乳腺癌尤其是维吾尔族早发性乳腺癌及双侧乳腺癌的发生密切相关。     

乳腺癌的影像普查技术进展

介绍了用于常规乳腺检测的X线摄影、超声成像和红外成像等各种影像学技术,通过分析这些技术的病理学以及影像学特征,找到它们在普查学中的意义。此外,还介绍了一种新兴的技术——热断层成像。     

全反式维甲酸对人乳腺癌MCF-7细胞凋亡的影响

目的:探讨全反式维甲酸(ATRA)对人乳腺癌MCF-7细胞凋亡的影响及作用途径.方法:在人乳腺癌细胞株MCF-7培养基中加入一定浓度ATRA和PKC-δ的专一抑制剂rottlerin(RO)并分组,通过SubG1assay by FACS、琼脂糖凝胶电泳检测基因组DNA ladder来观察ATRA对MCF-7的影响.结果:在浓度为5μM的ATRA作用下,MCF-7的凋亡率显著高于其它各组(P＜0.01),并可观察到明显梯状DNA.结论:ATRA能够诱导乳腺癌MCF-7细胞凋亡,但受PKC-δ的专一抑制剂RO的抑制.     

实时荧光定量PCR检测乳腺癌SOCS2基因表达

目的检测乳腺良恶性组织中细胞因子信号转导抑制因子（supressors of cytokine signaling,SOCS2）的mRNA表达及其临床病理意义。方法以18SrRNA为内j对照采用实时荧光定量PCR法,定量测定新鲜乳腺癌组织、癌旁组织和乳腺良性增生组织中。SOCS2 mRNA的表达并分析其与临床病理指标的关系。结果各组阳性率：乳腺癌35.00％（14／40）、癌旁乳腺组织100％（15／15）和乳腺良性增生组织81.25％（13／16）,其表达之间的差异具有统计学意义（P〈0．05）;乳腺癌组织的SOCS2表达水平与TNM分期和淋巴结转移呈明显的相关性（P〈0,05）。结论SOCS2在乳腺癌中的表达可能提示患者具有较好的预后。     

乳腺原发性腺泡细胞癌临床病理诊断

目的探讨乳腺原发性腺泡细胞癌的临床病理特征及诊断和鉴别诊断。方法对1例乳腺原发性腺泡细胞癌进行光镜观察及免疫组化标记。结果癌细胞由同种细胞组成,排列成实性巢状,细胞核圆形,胞质内富含颗粒,胞质嗜酸性或空泡状,透明细胞常见;免疫组化特征性表达CK、lysozyme、α-anti-chymotrypsin等抗体,有助于与其他肿瘤鉴别。结论乳腺腺泡细胞癌非常罕见,需要与乳腺浸润性导管癌、腺肌上皮瘤、颗粒细胞癌等鉴别。     

乳腺叶状肿瘤的形态学和免疫组织化学研究

目的观察乳腺叶状肿瘤（phyllodes tumours,PTs）的形态学和免疫组织化学特征,并探讨其诊断标准。方法对21例PTs进行组织学观察和免疫组化SP法检测,并选取5例乳腺纤维腺瘤和5例乳腺腺病标本作为对照组。使用一抗包括CK-pan、EMA、SMA、p53、S-100蛋白、CD117、CD34、CD99、bc l-2、ER、PR、K i-67、CD10。结果21例PTs大体上均表现为界限清楚的肿块,且呈分叶状。肿瘤由具有双层排列的上皮成分以及过度生长的间质成分组成。根据间质的过度生长程度、细胞的异型程度、核分裂数、肿瘤边缘情况、有无异源性成分以及肿瘤性坏死等继发性改变将其分为良性、交界性和恶性3个级别。间质细胞免疫组化表达情况：CKpan：0/21、EMA：0/21、SMA：17/21、CD117：6/21、CD34：18/21、S-100蛋白：2/21、CD99：13/21、CD10：8/21、PR：5/21、ER：4/21、p53：18/21、K i-67：3%~10%、bc l-2：15/21。结论PTs的诊断主要依据组织学观察,免疫组化CD117、CD34、CD99、CD10、bc l-2的检测可以起到一定的辅助作用。     

Grading invasive ductal carcinoma of the breast: advantages of using automated proliferation index instead of mitotic count

Breast carcinomas are graded according to the “Nottingham modification of the Bloom–Richardson system” (SBR). The system is hindered, however, by lack of precision in assessing all three parameters including nuclear grade, mitosis, and tubular formation, leading to an element of subjectivity. Our objective was to evaluate a new grading system [the nuclear grade plus proliferation (N+P) system] for subjectivity, ease, and better representation of tumor biology. Its components are nuclear grade and automated proliferation index. Invasive ductal carcinomas, consisting of 137 SBR grade I, 247 grade II, and 266 grade III, were re-evaluated by the N+P system. The two systems were compared with each other and correlated with patients’ overall survival, tumor size, angiolymphatic invasion, lymph node status, and biomarker status including estrogen receptor, progesterone receptor, p53, epidermal growth factor receptor, BCL-2, and Her-2. Although there was an agreement between the two systems with histologic and prognostic parameters studied, there was 37% disagreement when grading individual tumors. Fifty-three percent of SBR grade II tumors were “down-graded” to N+P grade I, and 7% were “up-graded” to N+P grade III. Distinction among the different histologic grades for overall survival curves was better indicated by the N+P than the SBR system.     

PI3K/Akt与染料木黄酮增敏阿霉素体外化疗人乳腺癌 MDA-MB-453 细胞的关系研究

目的 观察染料木黄酮(GEN)对HER2/neu高表达人乳腺癌MDA-MB-453细胞PI3K/Akt信号途径的抑制作用,探讨其在GEN增敏阿霉素(DOX)体外化疗乳腺癌MDA-MB-453细胞中的作用.方法 GEN、PI3K特异性抑制剂渥曼青霉素(WT)和DOX单独或联合处理体外培养的MDA-MB-453细胞,免疫细胞化学法检测HER-2/neu蛋白表达,免疫印迹法检测总Akt和磷酸化Akt蛋白(p-Akt)表达.结果 GEN对MDA-MB-453细胞HER2/neu和总Akt蛋白没有明显影响,但可明显降低p-Akt蛋白水平;同时WT也能明显降低p-Akt蛋白,并显著增强DOX抑制MDA-MB-453细胞生长的作用.结论 GEN增敏DOX体外化疗乳腺癌MDA-MB-453细胞株可能与其抑制PI3K/Akt信号途径有关.     

A metastatic renal carcinoid tumor presenting as breast mass: a diagnostic dilemma

We present clinicopathological and cytological findings of a well-defined breast mass in a patient with history of primary renal carcinoid tumor. Fine-needle aspiration (FNA) cytology showed monotonous tumor cells with plasmacytoid appearance arranged singly and in small clusters. Occasional tumor cells were arranged in acinar architecture resembling glandular differentiation. Tumor cells showed fine speckled chromatin. The unusual location for metastasis of this rare type of carcinoid tumor and overlapping cytological features with primary mammary carcinoma led to an erroneous preliminary cytological diagnosis of primary breast carcinoma with plasmacytoid features. Tumor cells in the corresponding cell block showed strong diffuse positivity for synapthophysin and pan-cytokeratin with weak focal positivity for chromogranin markers. These patterns of immunostaining were similar to the original renal carcinoid tumor. To the best of our knowledge, a few cases of carcinoid tumor metastatic to the breast have been reported in the literature and more than half of these cases were initially misdiagnosed as primary breast carcinoma causing unnecessary surgical treatment. This is a first reported case of metastatic renal carcinoid tumor into breast diagnosed with FNA biopsy. This report highlights the cytological features of well-differentiated neuroendocrine tumor (carcinoid tumor) and its potential diagnostic pitfalls.