乳腺癌伴神经内分泌分化及与预后的关系

目的　探讨乳腺癌中神经内分泌细胞的存在及与预后的关系。方法　采用免疫组化S P法对 5 8例乳腺癌手术标本进行神经内分泌抗体NSE ,Sy ,CgA的测定 ,并用电镜检查证实之 ,同时进行淋巴结转移情况分析。结果　 5 8例乳腺癌病人中NSE ,Sy ,CgA三种抗体表达阳性者 14例 ,占 2 4% ,电镜检查找见肿瘤细胞中存在神经内分泌颗粒。NE+ 者淋巴结转移率 (5 7% )较NE-者淋巴结转移率为高 (2 7% ) ,P <0 0 5。结论　乳腺癌伴有神经内分泌分化是肿瘤异质性的表现 ,是乳腺癌的一种特殊类型 ,具有与一般类型乳腺癌不完全一致的生物学行为 ,在乳腺癌术后治疗方案的决策上需引起应有的重视。

The Association between Neuroendocrine Differentiation in Carcinoma of the Mammary and its Prognosis

Objective To explore the relationship between the presence of neuroendocrine (NE) cell in breast cancer and some clinical pathologic factors related to prognosis. Methods Collecting 58 cases who were performed the operation of breast cancer by means of S-P immunohistochemical method to examine the expression of neuroendocrine index such as NSE,Sy,CgA, Subsequent electronic microscopic examination was done to verify it.NE cells in carcinoma which were probably related to axillary lymph node metastatic status were analysed. Results 14 of 58 cases were positive in NSE,Sy,CgA immunohistochemical reaction,which occupied 24% in total,many electroinic dense granules in their cytoplasm were seen.In the group of NE positive expression,incidence of lymph node metastasis was higher than that of NE negative group (57%,27%, P <0.05).Conclusions Neuroendocrine differentiation in carcinomas of the mammary was the heterogenicity of carcinoma originationg from breast gland.It was a specific type of breast carcinoma.They did not have any conformable biological behavior than that of ordinary pathological subdivision so that adopting suitable methods for treatment after operation should be paid much attention to.