乳腺癌组织内微血管定量与转移的关系

肿瘤内微血管定量是反映乳腺癌预后的重要参数。血管计数和密度级别高的乳腺癌易发生转移或复发。微血管定量与乳腺癌浸润周围血管有关。微血管生成除肿瘤源性因素外，还与肿瘤相关的炎性细胞等因素有关。     

乳腺癌类固醇激素受体的免疫组化细胞原位定量研究

应用图像分析技术对75例女性乳癌类固醇激素受体(SR)免疫组织化学染色结果进行定量测定。结果显示,SR阳性的光密度值与染色强度呈正相关;SR的阳性率及含量与乳癌的组织学分级及腋淋巴结的转移状况明显相关,提示SR含量高的乳癌恶性程度低,不易发生淋巴结转移。图像分析技术克服了半定量法的主观误差,结果精确可靠,它为肿瘤生物学特性的研究提供了一种新型定量指标。     

双重免疫组化染色在肿瘤内微血管密度测定中的应用

微血管密度是许多恶性肿瘤的重要预后因素。研究肿瘤内微血管密度，一般采用免疫组化法［1］。用FⅧUEAl、CD31、CD34抗体均可标记血管内皮细胞。有人认为FⅧ是血管内皮标记的“金标准”，但不能区分血管和淋巴管［2］。为了客观准确地区分血管和淋巴管，我们用生物素化荆豆凝集素（UEA1／BIO）和四型胶原（collagenⅣ）单克隆抗体，采用双重免疫组化染色取得了明显的效果。1材料和方法1．1材料舌粘膜鳞癌60例，舌粘膜白斑10例。1．2试剂第一抗体UEA1／BIO和collagenⅣ以及双重染色试剂盒（Zymed公司产品，USA）。1．3方法（1）石…     

跟腱内微血管定量研究

跟腱的自然断裂好发于附着在跟骨结节上方２￣６ｃｍ范围内，先前的血管造影研究表明该区域是一个“无血管区”，但至今仍然没有腱内血代的定量研究报导，近年来显微技术的较快发展为微血管研究提供了有利条件，本文对１５具新鲜成年男性尸体，用５％明胶墨汁行Ｇｕｏ动脉灌注，对２２例跟腱进行了组织学切片，微血管及毛细血管计数，观测了跟腱内各不同部位血管数量，结果表明跟腱中部血管较起、止点均少，且随年龄增长而逐渐减少，     

乳腺癌组织中郎罕细胞免疫组化研究

应用ＡＢＣ法对１４１例乳腺癌组织的郎罕细胞进行Ｓ－１００蛋白抗体标记。结果发现Ｓ－１００蛋白阳性的ＬＣ分布差异与乳腺癌的肿块大小，分化程度，淋巴结转移，临床分期，组织学类型及生存期有关（Ｐ＜０．００１）；而与乳腺癌的发病年龄无关（Ｐ＞０．００５）。因此检测乳腺癌组织中郎罕细胞的Ｓ－１００蛋白表达，对临床指导治疗及估计预后可能有一定的帮助。     

乳腺癌MMP-2表达与间质微血管密度和肿瘤转移的关系

目的 :研究乳腺癌组织中基质金属蛋白酶 2 (MMP 2 )的表达特点 ,探讨其与间质微血管密度及肿瘤转移的关系。方法 :应用免疫组化S P法 ,检测 49例乳腺癌、10例癌旁正常组织MMP 2的表达 ,并在CD34染色切片上检测间质微血管密度(MVD)。结果 :乳腺癌组织MMP 2的表达 (75 5 % )明显高于癌旁正常组织 (30 % ) ,二者之间差异有显著性 (P <0 0 1) ;MMP 2阳性组MVD均值 (5 4 93± 13 86 )高于MMP 2阴性组 (4 1 2 8± 11 6 9) ,MMP 2的表达与MVD呈正相关 (P <0 0 1)。此外 ,乳腺癌MMP 2的表达与组织学分级、淋巴结转移密切相关 (P <0 0 5 ) ,而与患者年龄、肿瘤大小、组织学分型、临床分期无关。结论 :MMP 2促进乳腺癌间质血管生成 ,促进肿瘤的侵袭和转移 ,有可能成为判定乳腺癌生物学行为和预后的重要指标     

肺鳞癌间质内微血管的定量研究

目的：探讨肺鳞癌间质内微血管与肺癌临床病理的关系；方法：应用ＦⅧ相关抗体，并采用ＬＳＡＢ法对８９例手术切除的肺鳞癌微血管进行定量检测。结果：有淋巴结转移组肺鳞癌微血管密度每２００倍视野５０．２±２２．８个，无转移组为３４±１９．１个，有洒巴结转移组微血管腔面积为８９６１．８±２８６８．９平方象素，无转移组为４０３７．４±２４２５．３平方象素，两者在两组间比较，差异均有极显著性意义；微血管密度及腔面     

主要组织相容性复合体在人乳腺癌组织的表达

目的通过观察主要组织相容性复合体(MHC)在乳腺癌组织的表达,探讨MHC与乳腺癌发生发展的关系,为临床进行乳腺癌的生物治疗提供实验依据。方法收集手术切除的人乳腺癌组织和癌旁相对正常乳腺组织,用免疫组织化学方法和图像分析技术,观察人白细胞抗原(HLA-DR)阳性细胞、CD4+T细胞和TCD8+T细胞在不同乳腺组织中的表达。结果在乳腺癌组织中HLA-DR阳性细胞平均光密度值和面数密度明显高于正常乳腺组织(P<0.05);CD4+T和TCD8+T细胞阳性细胞面数密度与正常乳腺组织相比明显减少(P<0.05),且CD4+T细胞多分布在HLA-DR阳性细胞附近。结论人乳腺癌局部微环境中HLA-DR阳性细胞数多于正常乳腺组织,CD4+T和TCD8+T在人乳腺癌组织低于乳腺正常组织。     

血管内皮生长因子和微血管密度在食管癌组织中的意义

目的 :探讨血管内皮生长因子 (VEGF)蛋白表达和微血管密度 (MVD)与食管癌临床病理的关系。方法 :应用免疫组织化学SABC法 ,以鼠抗VEGF、兔抗FⅧRAg、UEA 1抗体标记 5 2例食管癌和 5例正常食管黏膜 ,观察其在不同分化程度、浸润深度和有无淋巴结转移食管癌中的表达及MVD情况。结果 :癌组织VEGF阳性 2 8例 (5 3 9% ) ,MVD平均为 5 1 3± 14 8。VEGF蛋白表达和MVD与癌组织分化程度、淋巴结转移有关 (P <0 0 5 ,P <0 0 1) ;与癌组织浸润深度无关 (P >0 0 5 )。结论 :提示VEGF与癌组织血管发生密切相关 ,VEGF蛋白表达和MVD可作为判断食管癌的恶性程度和预后的生物学指标     

Microvessel quantitation and prognosis in invasive breast carcinoma.

The prognostic significance of microvessel quantitation in invasive breast carcinoma was analyzed in a study group that comprised 88 patients with axillary node-negative carcinoma and 32 patients with axillary node-positive carcinoma who had a minimum follow-up period of 9 years. Microvessels were identified by immunohistochemistry using antibodies to endothelial markers, including factor VIII-related antigen and blood group isoantigens (ABH). Factor VIII-related antigen staining provided more consistent results for microvessel quantitation than did staining for ABH isoantigens. The three most vascular areas within a tumor were selected, and the microvessels within a x200 microscopic field of each area were counted by two investigators simultaneously. Node-positive carcinomas demonstrated significantly higher microvessel counts than did node-negative carcinomas (mean +/- SD, 99 +/- 42 and 73 +/- 22, respectively; P less than .001). In node-negative carcinomas, tumors from patients who experienced distant recurrence had higher microvessel counts than did tumors from patients who were disease-free (84 +/- 19 and 70 +/- 22; P = .01). Similarly, in patients with node-positive carcinoma, microvessel counts were considerably higher in tumors from patients who experienced distant recurrence than in patients who did not, although the difference did not reach statistical significance (113 +/- 44 and 93 +/- 34, respectively). Among patients with node-negative carcinoma, those with a microvessel count of less than 84 had a recurrence rate of 20% compared with 57% in patients with counts greater than 84 (P = .003). Microvessel counts were independent of histologic parameters, ploidy status, and S-phase fraction but correlated with peritumoral vascular invasion. Both microvessel counts and vascular invasion were independent prognostic parameters by multivariate analysis. High vessel counts may represent increased tumor angiogenesis and are correlated with tumor aggressiveness. Microvessel quantitation may be an additional prognostic factor that, when used in conjunction with more established parameters, can help in appropriate patient management.     

乳腺浸润性导管癌中促性腺激素释放激素受体的表达及意义

目的 探讨促性腺激素释放激素受体(gonadotropin-releasing hormone,GnRHR)在乳腺浸润性导管癌中的表达及意义.方法 采用免疫组化方法 检测50例乳腺浸润性导管癌及18例正常乳腺组织中的GnRHR.结果 乳腺浸润性导管癌中GnRHR的阳性表达为68%(34/50).其中乳腺癌 G1组的阳性表达(92.3%,12/13)与G3组的阳性表达(46.2%,6/13)之间的差异有统计学意义(P<0.05).乳腺癌G3组的阳性表达和正常乳腺组织的阳性表达(94.4%,17/18)之间的差异有统计学意义(P<0.01).结论 大多数正常乳腺组织的GnRHR虽有表达,但呈弱阳性表达,而多数浸润性导管癌GnRHR则呈强阳性表达,提示乳腺组织的分化程度影响肿瘤组织内GnRHR的表达.     

Mesothelial markers in high-grade breast carcinoma

Duhig E E, Kalpakos L, Yang I A & Clarke B E
(2011) Histopathology 59 , 957–964 Mesothelial markers in high‐grade breast carcinoma Aims: Advances in molecular profiling have subdivided breast carcinomas into distinct subtypes. Basal carcinomas are generally oestrogen receptor (ER)?progesterone receptor (PR)?/human epidermal growth factor receptor 2 (HER2)?, and cytokeratin (CK)5/6+. This profile overlaps with that of mesothelial cells. This study of high‐grade breast carcinomas was undertaken to determine the expression of mesothelial markers. Methods and results: Immunohistochemistry was performed on 23 basal‐like breast carcinomas and 30 high‐grade breast carcinomas with variable ER, PR and HER2 expression. The incidence of staining of CK5/6, CK14, calretinin, Wilms’ tumour 1 (WT1), thrombomodulin and epithelial membrane antigen was assessed statistically. CK14 staining was more specifically associated with triple‐negative tumours than CK5/6. Calretinin positivity was statistically associated with basal‐like carcinomas. WT1 and thrombomodulin expression was infrequent and limited to a small number of non‐basal carcinomas. Conclusions: There is an overlap between the immunophenotype of mesothelial cells and that of basal‐like carcinomas of breast. Positive calretinin and CK5/6 are not specific, and may be seen in both mesothelial cells and basal‐like breast carcinomas. Negative ER and PR of basal carcinomas may also bias the observer against a breast origin. However, other negative mesothelial markers, such as WT1 and thrombomodulin, may help point to the correct diagnosis.     

Keratin expression in the normal breast and in breast carcinoma

The immunohistochemical reactivities of 69 cases of breast carcinoma were examined on methacarn-fixed, paraffin-embedded sections using eight different monoclonal antibodies which recognize one or a few keratin polypeptides. In the normal breast, the monoclonal antibodies RPN1162, RPN1165 and AE1 stained almost all the luminal cells but not the basal (myoepithelial) cells. The monoclonal antibodies 35BH11, M20, CK5 and CK8.12 stained only a subset of the luminal cells. In contrast, 312C8-1 stained basal cells but not luminal cells. All the tumour specimens reacted with AE1, while over 80% of them also reacted with 35BH11 (57/69), CK5 (57/69) and RPN1165 (55/69); 30% reacted with CK8.12 (21/69) and 16% with RPN1162 (11/69). Basal cell-specific keratin, as defined by 312C8-1, was detected in only 1% of cases (1/69). Monoclonal antibodies to different keratin polypeptides may be of use in the characterization and subdivision of breast cancer.     

Clinicopathological significance of invasive micropapillary carcinoma component in invasive breast carcinoma

Invasive micropapillary carcinoma (IMP) of the breast is a rare variant of invasive breast carcinoma and most cases of IMP are associated with nodal metastasis and lymphatic invasion. Lesions composed of an IMP component alone are rare and almost always coexist with other pathological components. However, few reports have documented IMP along with its proportion and the coexistent pathological type. We analyzed the total 486 breast cancer lesions operated in our hospital in 1998. We classified the lesions into five groups by the proportion of the IMP component in each lesion. Then we evaluated the incidence of nodal metastasis and lymphatic invasion in each group. The incidence of the invasive carcinoma containing any IMP components was 8.4%. The incidence of nodal metastasis and lymphatic invasion in lesions with an IMP component were significantly higher than that in those with no IMP. No correlation was seen between the incidence of nodal metastasis and the coexistent pathological type, shape of tumor clusters, nuclear grade and the expression of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 and gross cystic disease fluid protein-15 in IMP components. The presence of IMP components was a significant predictive factor for nodal metastasis, even if it is detected in only a small proportion of the tumor.     

乳腺癌波形蛋白表达的生物学意义

应用波形蛋白童克隆抗体（Ｖｉｍ）免疫组化ＡＢＣ法对７５例乳腺癌进行标记分析。结果显示，Ｖｉｍ阳性３４例，阳性率４５．３％。统计分析表明，Ｖｉｍ表达与肿瘤的组织学分级有关（Ｐ＜０．００５），Ｖｉｍ阳性肿瘤的ＡｇＮＯＲ均数大于阴性组）Ｐ＜０．０１），Ｖｉｍ阳性组病人的５年生存率低（Ｐ＜０．００５）。以上提示了乳腺癌Ｖｉｍ表达是肿瘤分化低、细胞增生活跃和病人预后不良的指征。     

乳腺基底细胞样癌的临床病理观察

目的 探讨乳腺基底细胞样癌(basal-like carcinoma,BLC))的临床病理特征、免疫表型特点及预后.方法 收集乳腺BLC 12例,总结其临床资料、大体及组织病理学特征,并进行免疫组化EnVision法染色.选用的抗体包括CK5/6、vimentin、CK8、ER、PR及c-erbB-2等.结果 本组患者均为女性,发病平均年龄40.4岁.12例乳腺BLC均为组织学Ⅲ级.肿瘤表现为无腺管的富于细胞的实性结构,周围有较少的纤维结缔组织间隔;大多数表现为推进式生长方式,周围有大量淋巴细胞浸润;排列呈实性巢状、片状、团块状及粗大带状结构伴有片状地图样坏死,肿瘤中央可出现无细胞结构的纤维瘢痕.肿瘤细胞胞质少呈合体状,核为圆形、卵圆形,胞核胞质比例高,核分裂象活跃.12例乳腺BLC的免疫表型均为ER、PR及c-erbB-2阴性,而CK5/6、CK8及vimentin阳性.结论 乳腺BLC是一种新的乳腺癌类型,具有独特的免疫组化特征、组织形态学特点及生物学特性,应作为一种独立的乳腺癌亚型加以认识.     

乳腺分泌脂质性癌临床病理分析

目的 探讨乳腺分泌脂质性癌(breast lipid-secreting carcinoma)临床病理特征.方法 对3例进行病理组织学观察、特殊染色PAS、AB染色和免疫组化标记ER、PR、Ki-67、c-erbB-2、p53等.结果 3例均为女性,年龄分别为44、54、50岁,均可触及乳腺肿块,肿瘤境界欠清楚,镜下肿瘤边缘呈浸润性生长,肿瘤主要由空泡状细胞即组织细胞样细胞和其它少量皮脂腺样细胞、大汗腺样细胞组成.AB、PAS染色阴性.免疫组化(SP法)瘤细胞示:ER、PR阴性、c-erbB-2、Ki-67、p53不同程度阳性.3例均术中快速切片诊断癌后,行乳腺改良根治手术.结论 乳腺分泌脂质性癌是一种相对少见,恶性度较高,预后较差的肿瘤,诊断主要依靠病理组织检查及特殊染色.免疫标记可帮鉴别诊断及判断预后.     

Clinicopathologic analysis of microscopically invasive breast carcinoma

Breast biopsy or mastectomy cases having diagnoses of carcinoma in situ with “microinvasion,” “minimal invasion,” “focal invasion,” or “suggestive of invasion” were reviewed and all histologically identified foci of invasive disease from each case were measured using an ocular micrometer. Cases in which any single focus of invasion was greater than 5 mm or the added size of separate invasive foci exceeded 10 mm were excluded, resulting in a study group of 75 patients. Invasive neoplasm was present in the initial biopsy in 69 of 75 cases (92%); however, residual invasive neoplasm was found in the subsequent lumpectomy/mastectomy from 14 of these (20%). In 59% of cases, two or more histologically separate foci of invasion were identified. Invasive foci consisted of isolated cells or cell clusters, each less than 1 mm (microfocal invasion), in 33% of cases. In 12 cases, the sum of individual invasive foci was 5 to 10 mm. Axillary lymph nodes (LN) from 5 of 69 patients (7%) contained metastatic carcinoma (four cases, one LN positive; one case, two LN positive). The cumulative sizes of all invasive foci in the LN-positive group were microfocal invasion (one case), 0.6 mm (one case), 1.1 mm, 2.5 mm, and 5.8 mm. The difference in frequency of axillary node metastasis between tumors with microfocal and measurable invasion (4.3% v 8.6%) was not statistically significant. Follow-up data were available on 55 cases (mean interval, 66.1 months). One (node-negative) patient had duct carcinoma in situ recurrence in the same breast 4 years after initial treatment. Another (with unknown node status) developed an axillary lymph node metastasis 13 months after initial treatment (96% disease-free survival). We conclude that microscopic stromal invasion in breast carcinoma, at least in the setting of significant in situ component, is often initiated from multiple foci. Patients with microscopically invasive breast carcinoma have a small but significant risk of axillary metastases, although a highly favorable survival.