乳腺良性疾病中激素受体的表达差异及意义

目的检测雌、孕激素受体(ER、PR)在乳腺增生症、单发与多发(肿瘤个数≥2个)乳腺纤维腺瘤中的表达,探讨三者之间的差异性。方法 72例乳腺增生症,203例单发与170例多发乳腺纤维腺瘤光学显微镜下回顾性观察,并对肿瘤组织进行ER、PR免疫组织化学染色。对多发者中81例患者术后予以三苯氧胺治疗(治疗组)。结果①乳腺多发纤维腺瘤患者的雌激素受体的阳性表达率与单发纤维腺瘤患者及乳腺增生患者相比,明显增高,差异有统计学意义(P0.05);②单发与多发纤维腺瘤PR阳性表达率及其高强度阳性表达率高于增生组(P0.05);③术后3年,170例多发乳腺纤维腺瘤中治疗组81例有4例复发,非治疗组89例有23例复发;203例单发者中13例复发(P0.05),多发非治疗组复发率显著高于多发治疗组和单发组(P0.05)。结论多发乳腺纤维腺瘤患者乳腺组织对雌激素敏感性较增生组和单发者更高,多发纤维腺瘤的复发率大于单发者,多发纤维腺瘤术后予以三苯氧胺治疗可以降低复发率。

Comparative analysis of hormone receptor expressions in benign disease of breast.

Objective To detect the expression of estrogen receptor （ER） , progestogen receptor （PR） in hyperplastic disease of breast, single and multiple breast fibroadenoma tissue, and explore the differences among them. Methods 72 cases of hyperplastic disease of breast, 203 cases of single breast fibroadenoma and 170 cases of multiple breast fibroadenoma were retrospectively observed under the light microscope. The immunohistoehemical staining was performed for ER, PR in tumor tissues. 81 cases of multiple breast flbroadenoma were treated with tamoxifen. Results （1）The positive rate and powerful positive rate of ER expression in multiple breast fibroadenoma were the highest （ P 〈 0.05 ）. （2）The positive rate and powerful positive rate of PR expression in single and multiple breast flbroadenoma were higher than that of the other （ P 〈 0. 05 ）. （3）Three years after operation, there were 4 recrudescent cases in 81 cases of multiple fibroadenoma who were cured with tamoxifen, 23 recrudes- cent eases in 89 cases of multiple fibroadenoma without tamoxifen, and 13 recrudescent cases in 203 cases of single fibroadenoma （ P 〈0.05 ）. The recrudescence rate of without tamoxifen multiple fibroadenoma is higher than that of single patient and treated tamoxifen. Conclusion The ER - positive and PR - positive rate of multiple flbroadenoma is higher than that of hyperplastic disease of breast and single breast fibroadenoma. The recrudescence rate of multiple fibroadenoma is higher than that of single patient. The rate of recurrence in multiple fibroadenoma will decreased after tamoxifen therapy.