乳腺癌广泛导管内癌成分与组织蛋白酶D Ki-67及单链DNA表达的关系及临床意义

目的 探讨乳腺癌广泛导管内癌成分（extensive intraductal component，EIC）、粉刺状坏死（comedo necrosls）、组织学分级与组织蛋白酶D（eathepsin D）、Kiab7、单链DNA（ssDNA）及c-erbB-2表达的关系。方法检测日本德岛乳腺门诊与东德岛医院1996年1月至1997年4月连续手术切除的59例乳腺浸润性导管癌标本。用免疫组化方法，检测59例乳腺浸润性导管癌中组织蛋白酶D（eathepsin D）、Ki-67、单链DNA及c-erbB-2的表达。结果EIC阳性组，肿瘤上皮细胞中的组织蛋白酶D为高表达（P=0．021），肿瘤间质细胞中的组织蛋白酶D表达差异无显著性意义。粉刺状坏死的出现，与c-erbB-2癌基因、肿瘤上皮细胞中的组织蛋白酶D和细胞增殖指数相关（P分别为0．042，0．006及0．013）。结论肿瘤上皮细胞中的组织蛋白酶D可能参与了EIC与粉刺状坏死的形成。EIC与粉刺状坏死的检测有临床应用价值。

Relationship between extensive intraductal component (EIC) in breast cancer and expression of cathepsin D,Ki-67, single stranded DNA

Objective To study the relationship between extensive intraductal component(EIC),comedo necrosis,histological grade in breast cancer and the expression of cathepsin D,Ki-67,single stranded DNA(ssDNA),c-erbB-2.Methods Expression of cathepsin D,Ki-67,single stranded DNA(ssDNA)and c-erbB-2 were measured immunohistochemically in 59 cases of breast invasive ductal carcinoma admitted in Medical School of Tokushima University between January 1996 and April 1997.Results In EIC positive group,there was higher expression of cathepsin D in tumor epithelial cell(P=0.021).No significant expression difference was found on cathepsin D in tumor stromal cell.Positive comedo necrosis was related with c-erbB-2,cathepsin D in tumor epithelial cell and proliferation index(P value was 0.042,0.006 and 0.013 respectively).Conclusion Cathepsin D in tumor epithelial cell may be involved in the formation of EIC and comedo necrosis.The evaluation of EIC and comedo necrosis is useful in clinical work.