乳腺Paget病细胞角蛋白-8、c-erbB-2、雌激素受体和孕激素受体的表达及意义

目的探讨乳腺Paget病中细胞角蛋白-8(CK-8)、c-erbB-2、雌激素受体(ER)和孕激素受体(PR)的表达及意义。方法对12例乳腺paget病组织进行免疫组织化学染色,检测CK-8、c-erbB-2、ER、PR在Paget细胞与同一例深部癌组织中表达的异同。结果Paget细胞CK-8表达阳性率为100%、c-erbB-2表达阳性率为91.67%,而ER、PR表达阳性率为16.67%。CK-8、c-erbB-2、ER及PR中每一标记物在Paget细胞和同一病例深部癌组织中阳性表达一致。结论乳腺Paget病内Paget细胞来源于乳腺深部存在的导管内癌或浸润性导管癌,是深部癌细胞在表皮内的扩散。     

乳腺癌COX-2表达及其与ER、PR、C-erbB-2的相关性

通过对环氧化酶-2（COX-2）、雌激素受体（ER）、孕激素受体（PR）及C—erbB-2在人乳腺癌的表达及其相互关系研究，进一步探讨COX-2在人乳腺癌发生、发展中的作用及临床意义。方法采用免疫组化方法检测49例人乳腺癌组织标本中COX-2、ER、PR及C—erbB-2的表达情况，分析COX-2在乳腺癌中的表达特征，并分析COX-2与ER、PR及C—erbB-2相互关系。结果49例人乳腺癌组织标本中COX-2表达阳性率61．22％，与肿瘤分期无关（P〉0．05）；与淋巴结转移阳性显著相关（P〈0．005）。COX-2的表达与ER、PR阴性状态有相关性（P〈0．05）。ER、PR阳性表达有同步性。C—erbB-2的阳性表达率59．18％，C—erbB-2的表达与淋巴结转移阳性者有关（P〈0．005）。在C—erbB-2阳性的29例中COX-2表达阳性率79．31％，而C—erbB-2阴性的20例中COX-2表达阳性率35％，两者相比有显著差异性（P〈0．005），COX-2的阳性表达与C—erbB-2的阳性表达有相关性。结论COX-2在人乳腺癌组织中呈高水平表达。COX-2在乳腺癌的发生、发展和转移中可能起重要作用。在检测乳腺癌淋巴结转移、ER，PR和C—erbB-2等生物学指标的同时，联合检测COX-2的表达，能更好地评估乳腺癌的进展情况和预后，并为应用选择性COX-2抑制剂防治乳腺癌提供了依据。     

乳腺良、恶性病变组织中MMP-26蛋白的表达及其与ER的关系

目的检测基质金属蛋白酶-26(MMP-26)蛋白在人乳腺良、恶性病变组织中的表达,及其与部分临床指标的关系,分析MMP-26在肿瘤进展中的作用及临床意义,并探讨雌激素及其受体(ER)对MMP-26蛋白表达调节作用。方法应用免疫组化SP法,检测MMP-26蛋白在正常乳腺组织、乳腺增生症、原位癌和乳腺浸润性导管癌(IDC)中的表达,以及ER在IDC中的表达并进行评分,结果用INSTAT统计软件分析。结果6例正常乳腺组织和8例乳腺增生症中,分别有1例MMP-26呈弱阳性表达,阳性率分别为16.7%和12.5%。4例原位癌中MMP-26全部阳性表达。在67例IDC中,有41例MMP-26阳性表达,阳性率为61.2%。MMP-26的表达与发病年龄、肿瘤大小、病理学分级无关,而与淋巴结转移密切相关(P<0.05)。MMP-26蛋白在IDC的阳性表达与ER在癌组织中的表达呈明显的负相关(P<0.01)。结论MMP-26在肿瘤浸润和转移中发挥重要作用;MMP-26在IDC中的表达可能受雌激素及其受体的调节。     

Immunocytochemical detection of estrogen and progesterone receptors in 124 human breast cancers

Monoclonal antibodies to human estrogen receptor (ER), and rabbit progesterone receptor (PR), also recognizing human PR, were used to detect the receptors by peroxidase immunocytochemistry in frozen sections of 124 primary breast carcinomas. Both ER and PR were almost exclusively located in carcinoma cell nuclei, with heterogeneous distribution and intensity. The staining results were evaluated semiquantitatively (histoscore), based on the percentage of positively stained carcinoma cells and nuclear staining intensity. The receptor status thus determined was as follows: ER+PR+ in 50 patients, ER+PR- in 23, ER-PR- in 26, and ER-PR+ in 3 patients. There was a 79% (ER) or 70% (PR) agreement in the positivity/negativity between the immunocytochemical and steroid-binding assay (in 102 patients) with a highly significant correlation. The histoscore values increased significantly with cytosol receptor levels (ER, r = 0.623, P less than 0.001; PR, r = 0.366, P less than 0.01).     

Estrogen and progesterone hormone receptor status in breast carcinoma: comparison of immunocytochemistry and immunohistochemistry

We evaluated the correlation between histologic and cytologic specimens in the determination of estrogen receptor (ER) and progesterone receptor (PR) status in breast carcinoma and investigated the causes of clinically significant discrepancies. We analyzed 70 immunoassays for ER and 60 for PR from 71 patients with breast carcinoma. Concordance between cytology and histology was 89% for ER and 63% for PR using scores from pathology reports. Concordance between cytology and histology was 98% for ER and 91% for PR using consensus scores (obtained after reevaluation by the team of pathologists). Thirty of 130 (23%) tests had clinically relevant discrepancies, 53% of which were caused by wrong interpretation of cytologic findings, 10% by wrong interpretation of histologic findings, 17% by sampling error and 20% were not available for reevaluation. Wrong interpretation of the results for ER and PR status in cytology was a far more frequent cause of clinically relevant discrepancies than sampling errors. The use of strict criteria is recommended.     

24例乳腺黏液癌临床病理分析

目的：探讨乳腺黏液癌的临床病理特点,临床进展及预后。方法：对24例乳腺黏液癌进行病理学形态观察,并采用Max Vision法进行免疫组织化学雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、Her-2、Ki-67染色,对其进行随访和分析并回顾相关文献。结果：18例单纯型乳腺黏液癌,其中1例伴有微乳头结构的乳腺黏液癌,6例混合型。免疫组织化学肿瘤细胞22例ER阳性,19例PR阳性,1例混合型黏液癌HER-2阳性,单纯型黏液癌HER-2均阴性,单纯型乳腺黏液癌和混合型乳腺黏液癌两者具有统计学意义(P<0.05)。结论：乳腺单纯型黏液癌特征是细胞巢漂浮在黏液湖中,并由富含毛细血管的纤维分割。细胞团大小和形态各异,核异型性不明显,ER、PR阳性,HER-2阴性。单纯型乳腺黏液癌(pure mucinous carcinoma,PMCs)生长缓慢,转移率低,可以行保乳手术。伴有微小乳头结构的乳腺黏液癌(mucinous micropapillary carcinoma,MUMPC)与混合型乳腺黏液癌易发生转移,建议行乳腺改良根治手术,术后辅助放化疗。     

Differential expression of estrogen, progesterone, and epidermal growth factor receptors in normal, benign, and malignant human breast tissues using dual staining immunohistochemistry.

Distribution of estrogen (ER), progesterone (PR) receptors, and epidermal growth factor (EGF) receptors was assayed by dual staining immunohistochemistry on 28 selected cytosolic ER-positive breast carcinomas and 22 nonmalignant breast tissues. ER-positive tumor cells were detected in 26 (93%) and EGF receptor positive tumor cells were detected in 7 (25%) carcinomas. In five tumors both ER and EGF receptors were detected but localized in distinct tumor cells. Only in one case of ductal carcinoma in situ co-expression was observed in a subset of tumor cells. In contrast, simultaneous expression of ER/PR and EGF receptors was observed in non-neoplastic ductal remnants in the majority of the carcinomas and the fibroadenomas. In addition, double-positive cells were occasionally detected in luminal epithelial cells of normal breast tissue and mastopathies. This study shows that ER/PR and EGF receptors in breast tumor cells are inversely related at the single cell level. However, demonstration of ER/PR and EGF receptors in individual normal luminal cells shows that expression is not mutually exclusive.     

浸润性乳腺癌术前FNA近似分子分型的临床意义

目的探讨浸润性乳腺癌术前细针吸取细胞学(fine needle aspiration,FNA)近似分子分型的可行性及临床意义。方法对42例女性原发性乳腺癌患者术前行细针穿刺术,涂片后进行细胞学诊断。利用免疫细胞化学技术检测ER、PR、HER2、CK5/6和EGFR表达情况,将乳腺癌近似分为腺腔A型(Luminal A)、腺腔B型(Luminal B)、纯HER2过表达型(pure HER2-overexpressing)、基底样型(basal-like)、HER2过表达基底样型(basal-HER2)及正常乳腺型(null)6个分子亚型。将其与术后对应标本的病理学及免疫组化结果进行比较。结果术前穿刺涂片诊断为"高度可疑乳腺癌"及"乳腺癌"的42例女性患者,经术后病理组织学证实均为浸润性乳腺癌,细胞学诊断准确率为100%。在42例乳腺癌细针吸取细胞涂片上利用免疫细胞化学进行术前各分子标记的检测,其中ER/PR阳性率为52.38%(22/42),HER2阳性率为42.86%(18/42),EGFR/CK5/6阳性率为19.04%(8/42)。相对应的石蜡切片经免疫组化检测,ER/PR阳性率分别为52.38%(22/42),HER2阳性率为40.48%(17/42),EGFR/CK5/6阳性率为23.81%(10/42)。其中,1例细胞涂片HER-2为阳性,而对应的石蜡切片为阴性;2例石蜡切片EGFR为阳性,而对应的细胞涂片为阴性,两种方法差异无统计学意义(P>0.05)。结论 FNA是术前诊断乳腺癌准确、易行的方法之一。浸润性乳腺癌术前FNA近似分子分型简单明了,切实可行。其有助于术前掌握乳腺癌的生物学特征,可能成为指导术前新辅助化疗、术式选择的有用指标。     

The effect of delay in fixation, different fixatives, and duration of fixation in estrogen and progesterone receptor results in breast carcinoma

Accurate determination of estrogen receptor (ER) and progesterone receptor (PR) status in breast carcinoma is essential. Preanalytic variation may contribute to discordant results. Recently, American Society of Clinical Oncology (ASCO)/College of American Pathologists (CAP) made recommendations to normalize fixation for breast biomarkers. To evaluate this, a 4-cm invasive lobular carcinoma was processed according to ASCO/CAP guidelines. The remainder was stored fresh at 4°C for 4 days and cut into biopsy-sized pieces. Each was fixed in 10% formalin, Pen-Fix (Richard-Allan Scientific, Kalamazoo, MI), Bouin solution, Sakura Molecular Fixative (Sakura Tissue-Tek Xpress, Torrance, CA), zinc formalin, or 15% formaldehyde for times ranging between 1 and 168 hours. Immunohistochemical studies for ER and PR were performed and interpreted. After 4 days at 4°C, all samples showed no degradation or ER/PR staining differences, except 2 Bouin-fixed samples, in comparison with the patient's sample processed according to ASCO/CAP guidelines. In our study, the preanalytic variables of fixative type, fixation time, and 4 days of ischemic time did not affect immunohistochemical accuracy for ER/PR.     

Effects of hormone therapy on estrogen synthesis from E1S in the mammary gland of postmenopausal women

OBJECTIVES: To investigate the effect of hormone therapy (HT) on the expression of hormone receptors and the ex vivo estrogen biosynthesis in the breast. METHODS: Comparative studies were carried out in breast tissue from 28 postmenopausal women undergoing breast surgery due to breast cancer (BC). Glandular breast tissue at least 1cm distant from the tumor was analyzed. Groups included patients having received HT (n=18), and non-user of HT (controls, n=10) prior to BC diagnosis. Steroid sulfatase (STS) activity was evaluated by incubating homogenized breast tissue with [3H]-estrone sulfate. Thin layer chromatography was performed to separate the products estrone (E1) and estradiol (E2). Histomorphometry for breast tissue composition and immunohistochemistry for expression of estrogen receptor (ER) alpha and beta as well as progesterone receptor (PR) were performed. RESULTS: In all groups, significantly more E2 than E1 was produced. Local E2 formation was higher in women having been treated with estrogen and progestogen (p< or =0.05). Local EZ formation was positively correlated with ER alpha expression (r(s)=0.5; p=0.03). Histomorphometrical and immunohistochemical outcomes did not differ between groups. However, the amount of vessels was higher in women having been treated with HT compared to controls (p=0.09). CONCLUSIONS: Long-term HT increases local estrogen formation in normal human breast tissue.     

Lack of expression of androgen receptor may play a critical role in transformation from in situ to invasive basal subtype of high-grade ductal carcinoma of the breast

Androgen receptor has been implicated in the pathogenesis of breast carcinoma. In this study, we explored the potential role of androgen receptor in breast cancer by analyzing its expression using immunohistochemistry and its relationship with tumor progress (ductal carcinoma in situ [DCIS] versus invasive ductal carcinoma [IDC]); nuclear grades (high grade [HG] versus non-high grade); expression of estrogen receptor (ER), progesterone receptor (PR), HER-2; and 3 molecular classifications: cytokeratin classification, triple (ER/PR/HER-2) negative classification, and ER/HER-2 classification in 184 breast carcinomas. We found that (1) lack of androgen receptor expression was associated with HG-IDC and with basal subtypes of HG-IDC, suggesting androgen receptor may play an important role in preventing the invasive transformation in this subgroup of breast carcinoma. (2) HG-IDC and HG-DCIS more frequently expressed androgen receptor than ER (55%-93% for androgen receptor and 18%-30% for ER) and were frequently androgen receptor+/ER- (63% for HG-DCIS and 39% for HG-IDC), which made androgen receptor a possible therapeutic target. (3) One third of HG-IDC was negative for androgen receptor, ER, PR, and HER-2, suggesting that further studies are needed to identify other key molecules for targeted therapy. We purpose that androgen receptor should be routinely measured for breast cancer.     

Rabbit monoclonal antibodies show higher sensitivity than mouse monoclonals for estrogen and progesterone receptor evaluation in breast cancer by immunohistochemistry

A novel generation of rabbit monoclonal antibodies for estrogen (ER) and progesterone (PR) receptor evaluation in breast cancer by immunohistochemistry has been released recently. We compared the novel RabMab anti-ER and anti-PR antibodies with the mouse monoclonal antibodies using a tissue microarray of breast carcinomas. Two cylinders (2mm diameter) of formalin-fixed, paraffin-embedded tissue were obtained from 24 invasive breast cancers and were immunostained using anti-ER mouse (1D5 and 6F11) and rabbit antibodies (SP1 and B644), and anti-PR mouse (PgR312 and PgR636) and rabbit antibodies (SP2 and B645). The immunohistochemistry was evaluated by considering positive those tumors in which more than 10% of the tumor cell nuclei stained independently on the staining intensity. Our results demonstrated that rabbit antibodies against ER have a similar staining pattern compared to the 6F11, but better than 1D5 from three different suppliers. The rabbit antibodies against PR (SP2 and B645) provide a stronger and sharper immunohistochemical signal compared to mouse antibodies (PgR636 and PgR312). Both ER and PR rabbit antibodies allow a lower cost per test because of higher working dilutions compared to mouse antibodies using the same procedure. The novel rabbit antibodies against ER and PR are highly sensitive for immunohistochemical testing of breast carcinomas.     

乳腺肉瘤样癌

观察乳腺肉瘤样癌的病理形态学特点,分型,并分析其与某些肿瘤的鉴别诊断。方法１５３８例乳腺恶性肿瘤中１５例（０．９８％）诊断为乳腺肉瘤样癌,行ＡＥ１／ＡＥ３、上皮膜抗原（ＥＭＡ）、波形蛋白、Ｓ－１００蛋白、肌动蛋白、雌激素受体（ＥＲ）和孕激素受体（ＰＲ）ＳＰ法免疫组织化学染色。另有６例是外院会诊病例,共２１例。结果按其肉瘤样成分的特点分为４个形态学类型：（１）多形肉瘤型：肉瘤样成分为多形肉瘤样。（２     

Apocrine carcinomas of the breast in Turkish women: hormone receptors, c-erbB-2 and p53 immunoexpression

The aims of this study were twofold: (i) to determine the occurrence frequency of apocrine carcinoma of the breast (ApBCa) in Turkish breast cancer (BCa) patients; and (ii) to evaluate the expression of estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), gross cystic disease protein-15 (GCDFP-15), c-erbB-2, and p53 in these cases. Six hundred and twenty-six cases of BCa were studied immunohistochemically (streptoavidin-biotin horseradish peroxidase method). The results of ApBCa were compared with those of invasive ductal carcinoma not otherwise specified type (IDC-NOS) cases of similar grade. Thirteen cases of ApBCa were encountered, accounting for 2.1% of all BCa cases. Immunohistochemically, ApBCa positivity was as follows: GCDFP-15 (100%), ER (39%), PR (8%), AR (54%), p53 (39%), and c-erbB-2 (85%). In the IDC-NOS group, GCDFP-15* was expressed in less than 50% of the tumors. The occurrence frequencies of the other markers were as follows: ER (69%), PR (69%)*, AR (46%), c-erbB-2 (0%)*, and p53 (31%), (*) indicating significant differences between the two groups.

For Turkish BCa patients, (i) the occurrence rate of ApBCa (2.1%) was high; and (ii) the following combination would allow for an immunohistochemical identification of ApBCa: GCDFP-15⁺, c-erbB-2⁺, and PR⁻.     

乳腺癌耐药相关蛋白在乳腺癌的表达及与临床病理参数相关性

目的探讨原发性乳腺癌中乳腺癌耐药相关蛋白(BCRP)表达与临床指标及病理参数的相关性。方法采用免疫组织化学方法检测BCRP及雌激素受体α(ERα)、孕激素受体(PR)、HER-2、P53等病理参数的表达,应用Kruskal-Wallis秩和检验和Spearman相关性检验分析BCRP与临床指标及病理参数的相关性。结果原发性乳腺癌中BCRP表达阳性率64.39%,癌旁组织中BCRP表达阳性率33.33%,两者相比有显著性差异(X~2=9.323,P=0.002);BCRP表达水平与患者年龄、病理类型、临床分级及淋巴结转移无关,而与患者是否绝经有关,未绝经患者乳腺癌组织中BCRP表达水平显著高于已绝经患者(X~2=6.928,P=0.008);BCRP表达水平与ERα(r=0.204,P=0.019)和HER-2表达水平呈正相关(r=0.246,P=0.004),与PR、P53表达水平不具有相关性。结论乳腺癌中BCRP蛋白表达水平明显高于癌旁正常组织,其表达强度与与患者体内雌激素水平及ERα及HER-2强度正相关。     

Immunohistochemical analysis of estrogen receptor alpha, estrogen receptor beta and progesterone receptor in normal human endometrium

The endometrium expresses estrogen (ER) and progesterone receptors (PR), which are involved in autocrine and paracrine regulation processes in response to estrogen and progesterone. The aim of the present study was to evaluate immunohistochemical distribution patterns of estrogen receptor alpha (ER alpha), estrogen receptor beta (ER beta) and PR in normal human endometrial tissue with the use of monoclonal antibodies. Human endometria were obtained from 17 premenopausal patients undergoing surgery for non-malignant diseases and were classified to be in proliferative, early secretory and late secretory phases by histological and anamnestical means. Distribution patterns of the steroid receptors were evaluated using the IRS-score and the Mann-Whitney rank-sum test was used to compare the means. Correlation was assessed with the Spearman factor and linear regression analysis. ER alpha and PR expression decreased significantly (p<0.05) in glandular epithelium from the proliferative to the late secretory phase. ER beta expression showed a similar significant decrease (p<0.05), although staining intensity was lower than that of ER alpha. A significant correlation between expression of all three steroid receptors was observed (p<0.001). Distribution patterns of ER alpha, ER beta and PR in normal human endometrium showed a cyclic variation during the menstrual cycle. A significant correlation between expression of ER alpha, ER beta and PR was also demonstrated using regression analysis, indicating dependence of expression of these three steroid receptors. The present study shows the presence of steroid receptors in human endometrial epithelium, indicating that these cells respond to estrogen and progesterone and thus playing a significant role in endometrial physiology.     

Apoptosis occurs more frequently in intraductal carcinoma than in infiltrating duct carcinoma of human breast cancer and correlates with altered p53 expression: detected by terminal-deoxynucleotidyl-transferase-mediated dUTP-FITC nick end labelling (TUNEL)

 

Aims:

We examined the relationship between apoptosis and three different major stages of human breast carcinoma: intraductal carcinoma (DCIS), infiltrating duct carcinoma (IDC) and metastatic carcinoma in lymph nodes. We also determined the correlation between apoptosis and oestrogen receptor (ER), progesterone receptor (PR) and p53.  

Methods and results:

The study investigates the extent of apoptosis in 63 breast carcinomas by in-situ end-labelling, in formalin-fixed, paraffin-processed tissue sections. The 63 breast carcinomas, included 22 DCISs, 26 IDCs, three infiltrating lobular carcinomas (ILC) and 12 metastatic lymph nodes. The apoptotic labelling index was higher in DCIS than IDC and metastatic carcinoma ( P  < 0.001, P  < 0.007, respectively). By immunohistochemistry, we also analysed p53, ER and PR. Apoptosis correlated significantly with p53 ( r  = 0.748, P  = 0.0004) in IDC. Also, ER correlated significantly with PR ( r  = 0.629, P  = 0.00001). No apparent correlation was found between the apoptosis and ER or PR.  

Conclusion:

Our data suggest that not only does apoptosis differ between intraductal carcinoma and infiltrating carcinoma but also it might be regulated by altered p53 expression.     

Estimation of hormone receptor status in fine-needle aspirates and paraffin-embedded sections from breast cancer using the novel rabbit monoclonal antibodies SP1 and SP2

We describe a method of immunocytochemical assessment of estrogen receptor (ER) status on alcohol-fixed smears obtained by fine-needle aspiration (FNA) from breast cancer patients, using a commercially available rabbit monoclonal antibody anti-ER (SP1) without any antigen retrieval. A series of 40 aspirates were analyzed and the results of ER status were compared with the respective formalin-fixed tissue using the same procedure and with assessment by the classical method using the mouse monoclonal antibody 6F11 (anti-ER) with antigen retrieval on paraffin sections. Twenty-four out of the 40 cases examined were positive at least by two methods and 16 were negative for all three determinations. The results obtained in the ER immunocytochemical assay on aspirates and paraffin sections using the antibody SP1 and those obtained on paraffin sections using the antibody 6F11 were quite similar. In one case the material was insufficient to interpret the reaction in the cytological specimen and only one case, with focal positivity reaction on paraffin sections, was negative in the cytological specimen. The intensity of nuclei staining in cytological smears of breast cancer cells was stronger than that observed by traditional methods. We also assessed progesterone receptor (PR) status on 40 paraffin-sections from breast cancer patients, using a commercially available rabbit monoclonal antibody anti-PR (SP2), with the same characteristics described for anti-ER (SP1). The results were compared with assessment by the classic method with mouse monoclonal antibody 1A6 (PR) on paraffin sections and total agreement was observed. Of the 40 cases examined, 18 were positive and 22 were negative for the two determinations. We conclude that the application of the ER method on alcohol-fixed smears/paraffin sections with the rabbit monoclonal antibody SP1, and the PR method on paraffin sections with the rabbit monoclonal antibody SP2, provide several advantages, such as high sensitivity and specificity of the reaction, stronger immunostaining, shorter procedures times, and avoidance of antigenic retrieval methods.     

Immunohistochemical detection of the estrogen receptor‐α and progesterone receptor in the canine pregnant uterus and placental labyrinth

The presence of hormone receptors is as important as the amount of hormone to predict hormone action. Therefore, the presence of estrogen receptors of the alpha subtype (ER‐α) and progesterone receptors (PR) was evaluated in six pregnant uteri including the placenta and in three postpartum uteri of dogs. This preliminary study is part of our immunohistochemical research project on steroid hormone receptor distribution in the canine female genital tract. Specific staining for ER‐α or PR was found only in cell nuclei. Staining for ER‐α was rare in the various cell types of pregnant and postpartum uteri. Staining for PR was absent or weak in epithelial cells. Moderate staining for PR was observed in endometrial stromal cells and myometrial smooth muscle cells, two cell types playing an important role in the maintenance of pregnancy. Stromal cells stained more frequently positive for ER‐α and PR than epithelial cells, indicating that both hormones may act on epithelial cells indirectly via stromal cells. In the placental labyrinth, fetal cells showed no evidence of ER‐α or PR. In contrast, both receptors were present in maternal mesenchymal cells that were located around the basement membrane of the maternal blood vessels. These cells showed signs of decidualization. No difference in PR distribution was seen between pregnant and postpartum uterine tissue, suggesting that during parturition the decrease in serum progesterone levels and the concomitant increase in the estrogen/progesterone ratio are probably more important than the decline in receptor availability. Anat Rec 260:42–50, 2000. © 2000 Wiley‐Liss, Inc.     

子宫内膜癌组织中内分泌分化细胞的生物学特性及意义

观察子宫内膜癌组织中内分泌分化细胞的增殖与凋亡状况、雌激素受体(ER)与孕激素受体(PR)表达,探讨其生物学及临床意义。手术切除或活检的子宫内膜癌标本50例。采用嗜铬素A(CgA)作为内分泌分化的标记,进行CgA／PCNA及CgA/TUNEL双重染色,观察内分泌分化细胞的增殖与凋亡状况;并进行CgA与生存素(Survivin)双重免疫组化染色,探讨生存素与内分泌分化细胞凋亡的关系。通过CgA/ER及CgA/PR双重免疫组化染色观察内分泌分化细胞的ER、PR表达。结果显示CgA阳性细胞呈PCNA及TUNEL染色阴性。CgA阳性细胞多表达Survivin。CgA阳性细胞密集的区域ER或PR减少明显。大多数CgA阳性细胞不表达ER或PR。结果提示子宫内膜癌组织的内分泌分化细胞属暂不增殖细胞群,亦极少发生凋亡,是较稳定的细胞群。内分泌分化细胞高表达Survivin可能是其逃避凋亡的分子学基础。子宫内膜癌组织的内分泌分化与ER和PR的减少有关。