抗人乳腺癌单抗M4G3在隐性乳腺癌诊断中的应用

目的 探讨抗人乳腺癌单克隆抗体M4G3在以腋淋巴结转移癌为首发症状的隐性乳腺癌诊断中的应用。方法 对切检为腋淋巴结转移癌而乳腺内未触及肿物的62例做M4G3免疫组织化学检测，并对其中M4G3阳性病例做全乳腺大切片检查，寻找乳腺内原发癌灶。结果 M4G3阳性58例(93．55％58／62)；乳腺内原发灶总检出率84．62％(44／52)；M4G3与雌激素受体／孕激素受体检测结果呈正相关(r1=0．394，P1=0．026；r2=0．357，P2=0．045)；随访结果表明M4G3阳性患者的原发灶在乳腺内。结论 抗人乳腺癌单克隆抗体M4G3检测在以腋淋巴结转移癌为首发症状的隐性乳腺癌的诊断中有重要临床价值，还需辅以全乳腺大切片检查配合诊断。

Significance of the monoclonal antibody M4G3 against human breast cancer in the diagnosis of the occult breast cancer

Objective To explore the application of M 4G 3 in the diagnosis of the occult breast cancer with the lymphatic metastasis as first symptom.Methods M 4G 3 was detected by immunohistochemistry SP method in 62 cases with axillary lymph nodes metastasis and without palpable breast mass.The whole organ section examination was performed in the M 4G 3 positive cases of those for searching primary focus.Results The positive rate of M 4G 3 staining was 93.55% (58/62).The detectable rate of primary focus in the breast was 84.62% (44/52).The examination results of M4G3 and ER or PgR positively correlated (r 1=0.394,P 1=0.026;r 2=0.357,P 2=0.045).The results of the follow-up verified further that the primary focus of the patients positive for M 4G 3 was in the breast.Conclusion The detection of M 4G 3 MoAb may play an important role in the diagnosis of occult breast cancer with the lymphatic metastasis as first symptom.Whole organ section examination was needed to cooperate with M 4G 3 assay.