乳腺叶状囊肉瘤的增殖细胞核抗原的表达及其意义

目的研究乳腺叶状囊肉瘤增殖细胞核抗原（ＰＣＮＡ）的表达及其临床病理意义。方法采用免疫组化ＳＰ法对１００例乳腺叶状囊肉瘤及３９例乳腺腺纤维瘤进行检测。结果叶状囊肉瘤中间质性瘤细胞呈ＰＣＮＡ阳性着色者８６例（８６％），不同组织学级别者ＰＣＮＡ指数之间有显著差异（Ｆ＝８５．３３，Ｐ＜０．０１），分化越差，ＰＣＮＡ平均指数越高，ＰＣＮＡ指数与组织学分级密切相关（ｒ′ｓ＝０．７７）。Ⅰ级叶状囊肉瘤与乳腺腺纤维瘤间质性瘤细胞丰富组的ＰＣＮＡ指数也有显著差异（ｔ＝３．４２，Ｐ＜０．０１）。ＰＣＮＡ指数与核分裂相计数间相关关系并不密切（ｒ＝０．３９）。结论用ＰＣＮＡ来反映乳腺叶状囊肉瘤增殖活性，辅助进行组织学分级，鉴别良恶交界性病变及估测预后，都具有一定的实用价值。

The expression of proliferating cell nuclear antigen in breast phylloides cystosarcoma and its significance

OBJECTIVE: To investigate the expression of proliferating cell nuclear antigen (PCNA) in breast phylloides cystosarcoma and its clinicopathological signification. METHODS: Immunohistochemistry (SP method) with monoclonal antibodies PC10 against PCNA was performed in 100 cases of phylloides cystosarcoma and 39 cases of adenofibroma. RESULTS: The positive rate of PCNA in phylloides cystosarcoma was 86%. The average PCNA index (PI) of phylloides cystosarcoma was significantly different among every histologic grading (F = 85.33, P < 0.01). The degree of differentiation was lower, the PI was higher. The PI was closely correlated with histologic grading (r's = 0.77). The PI in grade I phylloides cystosarcoma was higher than that in the group of adenofibroma with abundant mesenchymal cells (t = 3.42, P < 0.01). There was only a low correlation between PI and mitotic figures in phylloides cystosarcoma (r = 0.39). CONCLUSIONS: These findings suggest that the detection of PCNA has considerable practical value in reflecting the proliferation of activity of phylloides cystosarcoma, assisting the pathologists to make histologic grading; distinguishing the malignancy from benign ones (differential diagnosis) and evaluating the prognosis.