乳腺导管内乳头状瘤及其癌变组织CD44v6蛋白表达的研究

背景与目的：CD44v6是乳腺上皮恶性转化中的一个重要成分,在乳腺良恶性病变中有不同的表达,但其在良恶性病变的鉴别诊断中的价值并没有得到很好和研究,本研究目的是检测CD44v6在乳腺导管内乳头状瘤及导管内乳头状瘤癌变组织中的表达,探讨CD44v6在乳腺导管内乳头状瘤诊断及鉴别诊断中的作用。方法：对49例导管内乳头状瘤,12例导管内乳头状瘤癌变,15例导管内癌,15例浸润性导管癌及20例正常乳腺组织的石蜡切片进行免疫组织化学染色。结果：在正常组织,导管内乳头状瘤,乳头状瘤癌变,导管内癌,浸润性导管癌中,肌上皮细胞（basal epithelial cell)的CD44v6蛋白表达阳性（＋＋／＋＋＋）率分别为95．00％,85。72％,66。66％,66。66％,0％,导管内乳头状瘤与乳头状瘤癌变之间无统计学差异（P＞0．05）,而上此细胞（luminal epithelial cell)的CD44v6蛋白表达阳性（＋＋／＋＋＋）率分别为5．00％,83．34％,93．33％,100％,导管内乳头状瘤与乳头状瘤癌变之间有统计学差异（P＜0．01）,结论：通过免疫组化检测CD44v6蛋白表达对诊断导管内乳头状瘤是否癌变具有重要参考价值。

Study of CD44v6 protein expression in intraductal papilloma and its malignant transformation of breast

Background &Objective:CD44v6 plays an important role in the malignant transformation of breast epithelia and is differentially expressed in normal and neoplastic breast tissue. The diagnostic value of this marker in differentiating malignant from benign breast lesions has not been well examined. This study was designed to evaluate the diagnostic value of CD44v6 protein in distinguishing between benign and malignant papillary lesions of the breast,which is be difficult morphologcally,by determining the level of CD44v6 expression in different lesions of the breast. Methods:The level of CD44v6 protein was detected by immunohistochemistry in 111 paraffin embeded blocks. Result:The positive expressive rates of CD44v6 protein in the basal epithelial cells of the normal tissue,intraductal papilloma,and its malignant transformation,intraductal carcinoma, invasive ductal carcinoma were 95 00%, 85 72%, 66 66%, 66 66%,and 0 00%respectively. The difference between the intraductal papilloma and its malignant transformation was not significant(P >0 05). However, the positive expressive rates of CD44v6 protein in the luminal epithelial cells of the above lesions were 5 00%, 20 41%, 83 34%, 93 33%,and 100%respectively. There was difference between intraductal papilloma and its malignant transformation(P< 0 01). Conclusion:CD44v6 detection by immunohistochemistry is useful in distinguishing intraductal papilloma from its malignant transformation of the breast