Clinicopathologic analysis of invasive micropapillary differentiation in breast carcinoma.

Invasive micropapillary carcinoma (IMPCa) of breast is histologically characterized by growth of cohesive tumor cell clusters within prominent clear spaces resembling dilated angiolymphatic vessels. In this study, eighty three breast carcinomas with IMPCa differentiation were identified by review of the invasive carcinoma cases in our institution and correlated retrospectively with standard clinicopathologic parameters and survival status relative to a control series of cases (mean follow up 7 years). IMPCa growth pattern was present in 6% of all breast carcinomas; it was generally a focal component in otherwise typical invasive ductal carcinoma. It comprised more than 80% of the total neoplasm in only 10 cases (12%), 50-80% of the neoplasm in 7 cases (8%), 20-50% of the neoplasm in 22 cases (26%) and less than 20% in 44 cases (53%). The mean tumor size was 4 cm, 22% invaded skin, and 58% were poorly differentiated, but 71% were ER positive. Axillary node metastases were present in 77% of cases, were typically multiple (51% had three or more positive), and usually contained an IMPCa component (81% of the cases). There was no significant difference in node status, ER status, size, tumor grade, or peritumoral angiolymphatic invasion between tumors with predominant (more than 50%) v/s focal IMPCa components. In both groups 46% of the patients died from their disease (mean interval to death = 36m). Skin involvement and nodal status were the only parameters which predicted poor survival (P =.01). The outcome of patients with IMPCa did not differ significantly from infiltrating ductal carcinomas of similar node status. In conclusion, our results suggest that IMPCa growth pattern may be a manifestation of aggressive behavior, as shown by frequent skin invasion and extensive nodal involvement. However, clinicopathologic features and outcome of IMPCa are not strongly dependent on the relative amount of micropapillary component.     

Increased expression of SDF-1/CXCR4 is associated with lymph node metastasis of invasive micropapillary carcinoma of the breast

Aims:  Stromal cell-derived factor-1 (SDF-1) and its receptor CXCR4 are implicated in tumour chemotaxis and metastasis. The aim was to examine their roles in the metastasis of invasive micropapillary carcinoma (IMPC) of the breast, a tumour with a high propensity for nodal spread.
Methods and results:  We compared the expression of SDF-1 and CXCR4 in 103 cases of breast cancer containing IMPC components with a control group of 96 cases of invasive ductal carcinoma (IDC), not otherwise specified type by immunohistochemistry and chemical in situ hybridization (CISH). The results showed that the predominant cytoplasmic expression of both SDF-1 and CXCR4 was greater in tumour cells of the IMPC components than in those of the non-IMPC components and the control IDC cases, and was correlated significantly with the number of positive lymph nodes ( P  < 0.05). SDF-1 expression on cell membranes was less frequently identified in IMPC than IDC ( P  = 0.021). Immunohistochemical detection of SDF-1 in endothelial cells of lymphatic vessels was more common in IMPC ( P   =  0.007) and correlated significantly with lymph node status ( P  = 0.002), although SDF-1 mRNA was rarely detected by CISH.
Conclusions:  This study suggests that up-regulation of cytoplasmic expression of SDF-1/CXCR4 might be one of the molecular mechanisms facilitating lymph node metastasis of IMPC.     

Inactivation of the PTEN gene protein product is associated with the invasiveness and metastasis, but not angiogenesis, of breast cancer

PTEN is a novel tumor-suppressor gene located on chromosomal band 10q23. Loss of PTEN function has been implicated in the progression of several types of cancer, but the correlation between loss of PTEN expression and advanced carcinomas is not well established. The capacity for angiogenesis of a tumor is known to play a very important role in growth and metastasis, and there have been reports that PTEN relates to angiogenesis. In the present study, formalin-fixed and paraffin embedded tissues from 101 patients with breast carcinomas, including 88 cases of invasive ductal carcinomas and 13 cases of ductal carcinoma in situ (DCIS), were evaluated by immunohistochemical methods for the expression of PTEN and vascular endothelial growth factor (VEGF), as well as microvessel density (MVD). The results were compared with the clinicopathologic parameters. There was no loss of PTEN expression in any of the cases of DCIS, but 28 (32%) of the 88 invasive cases did not express PTEN. Loss of PTEN expression was associated with lymph node metastasis ( P  = 0.03), but did not correlate with tumor size, tumor grade, MVD or recurrence. VEGF expression significantly correlated with lymph node metastasis in invasive ductal carcinoma ( P  = 0.01). There was no correlation between the expression of PTEN and that of VEGF ( P  = 0.63). The present study suggests that loss of PTEN expression is common and correlates with tumor progression and lymph node metastasis in breast carcinoma. The relationship between loss of PTEN and progression of breast cancer may not be explained by modulation of angiogenesis.     

乳腺癌EphA2和EphrinAl的表达及与临床病理因素的关系

目的　研究云南白族地区乳腺癌EphA2和EphrinAl的表达及其与临床病理因素的关系。 方法　用免疫组织化学(IHC)检测乳腺癌组织中EphA2、EphrinAl的表达,比较各自表达情况与临床病理因素的关系及二者间的相关性。 结果　EphA2、EphrinAl主要表达于肿瘤细胞和血管内皮细胞的胞浆和胞膜,呈棕黄色或棕褐色。150 例乳腺癌组织中,EphA2、EphrinAl阳性表达分别为123例、129例,阳性率分别为82%、86%。二者的阳性率与患者年龄无相关性(P>0.05),而与病理类型、肿瘤大小、淋巴结转移、临床分期和组织学分级有相关性(P<0.05)。浸润性导管癌EphA2和EphrinAl阳性率较导管内癌的高;肿瘤较大组、淋巴结转移组、临床分期较晚者、组织学分级较高组EphA2和EphrinAl的阳性率分别高于肿瘤较小组、无淋巴结转移组、临床分期较早者、组织学分级较低组EphA2和EphrinAl的阳性率。EphA2和EphrinAl阳性染色共同定位于大致相同的肿瘤区域和血管内皮细胞,二者的阳性率有相关性(P<0.05)。 结论　EphA2、EphrinAl在乳腺癌高表达,并与其发生发展、侵袭转移及恶性程度有关,有望成为乳腺癌预后评估标志物,为早期诊断和靶向治疗提供新思路。     

前列腺干细胞抗原的表达在乳腺浸润性微乳头状癌中的意义

目的 探讨乳腺浸润性微乳头状癌(IMPC)中前列腺干细胞抗原(PSCA)在蛋白和mRNA水平的表达及其与临床病理特征的关系.方法 采用免疫组织化学(LSAB法)检测66例IMPC、67例非特殊型浸润性导管癌(IDC-NOS)中PSCA的表达,比较其差异并分析PSCA的表达与IMPC临床病理特征之间的关系.采用逆转录聚合酶链反应(RT-PCR)检测10例IMPC和10例IDC-NOS癌组织及其对应的正常乳腺组织中PSCA mRNA的表达水平.结果 免疫组织化学染色结果显示,PSCA在66例IMPC中有47例高表达(71.2%,47/66),67例IDC-NOS中35例高表达(52.2%,35/67),两组表达水平之间的差异具有统计学意义(P=0.024);IMPC中PSCA的表达与淋巴结转移呈正相关(P=0.039).RT-PCR结果显示,PSCA在10例IMPC和10例IDC-NOS癌组织中各有7例和5例表达,且全部高于对应的正常乳腺组织;IMPC癌组织中PSCA表达强度明显高于IDC-NOS癌组织.结论 PSCA的表达可能在IMPC淋巴结转移过程中发挥了重要作用.

Abstract：

Objective To study the expression of prostate stem cell antigen (PSCA) at protein and mRNA levels in invasive micropapillary carcinoma of the breast (IMPC) and to analyze the relationship between PSCA expression and clinicopathologic features. Methods The expression of PSCA protein was analyzed by immunohistochemistry (LSAB) in 66 cases of IMPC and 67 cases of invasive ductal carcinoma, not otherwise specified (IDC-NOS). The association between PSCA expression and clinicopathologic features was also analyzed in IMPC. Furthermore, RT-PCR was used to detect PSCA mRNA in 10 cases of primary IMPC and 10 cases of primary IDC-NOS with paired normal breast tissues, each from the same subject. Results Immunohistochemical analysis revealed the overexpression of PSCA in 47 of 66 (71.2%) cases of IMPC and 35 of 67 (52.2%) IDC-NOS. Statistical analysis showed a significant difference of PSCA expression between IMPC and IDC-NOS (P=0.024). In IMPC, the expression of PSCA was correlated with lymph nodes metastasis (P=0.039). RT-PCR showed the mRNA level of PSCA was significantly higher in primary IMPC and IDC-NOS tissue than that in paired normal breast tissue (7/10 and 5/10, respectively), and it was also significantly higher in primary IMPC tissue than that in IDC-NOS tissue.Conclusion PSCA might play an important role in lymph node metastasis in IMPC.     

p34cdc2 in invasive breast cancer: relationship to DNA content, Ki67 index and c-erbB-2 expression

Aims : One-hundred and eighty-eight cases of human mammary carcinoma were examined immunohistochemically for their expression of Ki67, p34^cdc2 and c-erbB-2. DNA image cytometry was performed to evaluate DNA ploidy, Auer type, S-phase fraction (SPF), 5c exceeding rate (5cER) and 2c deviation index (2cDI).  

Methods and results

One-hundred and sixty-eight cases were invasive ductal carcinomas, 20 were of invasive lobular type. Routinely assessed oestrogen and progesterone receptor scores were available. The results were analysed statistically in comparison to tumour type, histopathological grade, lymph node status, menopausal status, patient age and overall survival. Ki67 ( P  < 0.002) and c-erbB-2 ( P  < 0.0001) correlated well with overall survival ( P  < 0.0008) and grade ( P  < 0.038) but not with lymph node status and tumour type. p34^cdc2 showed a trend towards a positive correlation with Ki67 ( P  < 0.058) and a significant negative correlation with receptor status ( P  < 0.008) but with none of the other parameters examined.  

Conclusions

No association between the DNA measured parameters (Auer type, SPF, 5cER and 2cDI) and survival was found. Our results suggest that c-erbB-2 and Ki67 are parameters which might, in combination with receptor status, help to define subgroups with different outcomes.     

CD44v4在乳腺浸润性导管癌中的表达及 其与浸润转移的关系

目的 探讨CD44v4在浸润性乳腺导管癌中的表达及其与浸润转移的关系。方法 选取2011年1月~2018年3月我院收治的乳腺浸润性导管癌185例设为观察组,另选取同期收治的乳腺良性疾病患者60例设为对照组,采用免疫组化法检测两组CD44v4的表达情况,并比较观察组CD44v4表达及临床病理因素情况。结果 观察组CD44v4阳性表达率为60.54%,高于对照组的5.00%,差异有统计学意义（P＜0.05）。CD44v4表达在不同年龄、绝经前后月经状况、原发瘤大小间比较,差异无统计学意义（P＞0.05）;不同TNM分期、组织学分级、淋巴结转移患者的CD44v4表达比较,差异有统计学意义（P＜0.05）。结论 CD44v4蛋白在乳腺浸润性导管癌患者中为高表达,检测其表达可作为判断肿瘤预后的新指标。     

Loss of bcl-2 expression in ductal carcinoma in situ of the breast relates to poor histological differentiation and to expression of p53 and c-erbB-2 proteins

Aim : This study (1) investigates the incidence of bcl-2 protein expression in a series of 108 cases of ductal carcinoma in situ (DCIS), including 25 with early invasive carcinoma, and (2) evaluates the relationship of bcl-2 expression to the histological grade of DCIS and to the expression of oestrogen receptor (ER), c-erbB-2 and p53 proteins.  

Methods and results

The expression of bcl-2, oestrogen receptor (ER), c-erbB-2 and p53 proteins was determined immunohistochemically. Cases were regarded as positive for individual antibodies when at least 10% of the DCIS cells showed positive staining. DCIS was graded histologically as well ( n  = 9), intermediately ( n  = 24), or poorly differentiated ( n  = 75). bcl-2 expression was documented in 57 cases (53%) and was strongly associated with the histological grade of DCIS ( P  < 0.0001). All cases of well-differentiated DCIS were bcl-2 positive and loss of bcl-2 expression was almost exclusively confined to poorly differentiated DCIS lesions. bcl-2 expression was also closely associated with positive ER status ( P  < 0.0001). Forty-seven of 57 (82%) bcl-2 positive cases were ER positive while 49/51 (96%) bcl-2 negative cases were ER negative. There was a significant inverse correlation between bcl-2 expression and both p53 protein expression ( P  = 0.0004) and c-erbB-2 expression ( P  < 0.0001). Nineteen of 24 (79%) p53 positive cases and 38/45 (84%) c-erbB-2 positive cases showed loss of bcl-2.  

Conclusions

Loss of bcl-2 expression occurs in poorly differentiated DCIS and is related to negative ER status and to positive p53 and c-erbB-2 status. This pattern of bcl-2 expression and its association with other biological markers in DCIS is similar to that reported in invasive breast carcinoma.     

Solid-papillary carcinoma of the breast: clinicopathological study of 20 cases

The purpose of the present paper was to evaluate the clinicopathological and biological features of 20 Japanese patients with solid-papillary carcinoma of the breast (SPC) or SPC associated with invasive breast cancer. All the patients were Japanese women, including two sisters. The mean age was 66.0 years. The incidence of SPC among all the breast cancers treated at two institutions was 1.1% and 1.7%, respectively. The mean disease-free interval was 4 years 11 months. Axillary lymph node metastasis or tumor recurrence did not occur in any of the cases. Fifteen cases of SPC contained invasive cancers that ranged from <5% to 60% of the entire tumor area. Histological types of invasive cancers were mucinous carcinoma in five cases and neuroendocrine cell carcinoma in 10 cases. These results indicate that SPC is a potential precursor lesion for neuroendocrine carcinoma as well as mucinous carcinoma. When all the cases were classified and analyzed according to both the 2002 tumor node metastasis (TNM) classification system and the Nottingham histological grade, SPC patients, even those with invasive cancers, seemed to have longer disease-free survival compared to patients with the other invasive breast cancers of matching grade and stage. Clinicopathologically, SPC could be regarded as a separate type of ductal carcinoma in situ.     

Invasive micropapillary carcinoma of the breast: high incidence of lymph node metastasis with extranodal extension and its immunohistochemical profile compared with invasive ductal carcinoma

AIMS: Invasive micropapillary carcinoma of the breast is an aggressive and distinctive variant of breast cancer. These tumours have a characteristic histological appearance and have been associated with a high incidence of axillary lymph node metastases and a poor clinical outcome. The aims of this study were to investigate the immunohistochemical profile of invasive micropapillary carcinoma of the breast, to compare it with invasive ductal carcinoma, and to identify the morphological parameters which predict its poor outcome. METHODS AND RESULTS: Fifty-three (2.6%) invasive micropapillary carcinomas of the breast from 2022 cases of infiltrating breast carcinomas were identified by retrospective review. The patient age at presentation ranged from 33 to 78 years (mean 52.5 years). The tumour size ranged from 5 to 70 mm (mean 27 mm). Eighty-two percent (43 of 53) were of high histological grade; 69% (33 of 48) of cases with axillary lymph node dissections had positive lymph nodes; and 75.5% (40 of 53) had lymphatic invasion: 46% (22 of 48) of cases had extranodal extension. Of lymph node-positive cases, 61% had four or more metastatic lymph nodes. Of tumours with tumour size >10 mm, 77% had positive lymph nodes. The percentages of cases positive for oestrogen receptor (ER) and progesterone receptor (PR) were 68% and 61%, respectively. These values were significantly higher than the values for invasive ductal carcinomas. p53 and c-erbB-2 were detected in 48% and 54% of cases, respectively. The mean value of Ki67 was 26%. Follow-up was available in 36 patients. Eight patients had local recurrences, nine patients had distant metastases, and 10 patients died of disease within a follow-up period of 9 years. CONCLUSION: Lymphotropism and an unfavourable prognosis are the hallmarks of this distinct entity. Prognostic markers such as ER, PR, p53, and c-erbB-2 failed to provide new criteria to allow discrimination of these tumours from other breast cancers.     

乳腺浸润性导管癌中ER、PR、Her-2、Ki-67表达与病理特征及预后的相关性

目的 探究Ki-67、ER、PR、Her-2等基因在乳腺浸润性导管癌（IDC）组织中的表达,分析其与患者临床病理特征及预后的相关性。方法 收集2013年1月~2014年12月广东医科大学附属医院病理科乳腺包埋石蜡块IDC组织74例。采用免疫组织化学法检测ER、PR、Her-2、Ki-67在IDC组织中的表达,分析其与患者年龄、组织学分级、TNM分期、淋巴结转移及预后的相关性。结果 ①不同年龄、组织学分级、淋巴结转移及TNM分期的IDC患者ER、PR表达情况比较,差异均无统计学意义（P＞0.05）;未发生淋巴结转移的IDC患者Her-2表达低于转移患者,差异有统计学意义（P＜0.05）;不同年龄、组织学分级、TNM分期的IDC患者Her-2表达比较,差异无统计学意义（P＞0.05）;不同TNM分期的IDC患者Ki-67表达情况比较,差异有统计学意义（P＜0.05）,不同年龄、组织学分级、淋巴结转移的IDC患者Ki-67表达比较,差异均无统计学意义（P＞0.05）。 ②Spearman相关性分析显示,ER与PR正相关,ER与Her-2、PR与Her-2负相关,ER、Ki-67和PR、Ki-67负相关,Her-2与Ki-67正相关。③Ki-67阳性表达的IDC患者病死率高于Ki-67阴性表达的患者,差异有统计学意义（P＜0.05）;不同ER、PR、Her-2表达情况的IDC患者病死率比较,差异无统计学意义（P＞0.05）;Ki-67阴性表达患者的总生存时间（OS）高于阳性表达患者,COX多因素分析显示,Ki-67阳性表达是影响IDC患者OS的独立因素（95%CI:0.212~0.865,P=0.018）。结论 Ki-67可作为乳腺浸润性导管癌危险评估的分子标志物,其阳性表达可影响乳腺癌患者的预后。ER、PR、Her-2的表达对乳腺浸润性导管癌患者的预后没有明显影响。     

Morphologic spectrum of estrogen receptor-negative breast carcinoma

CONTEXT: Estrogen receptor (ER)-negative breast carcinomas are a heterogeneous group of breast cancers that are generally thought to be aggressive. OBJECTIVE: To determine the morphologic and immunohistochemical spectrum of a consecutive series of ER-negative breast carcinomas, in an attempt to understand the pathogenesis and behavior of these lesions. DESIGN: Seventy-four consecutive cases of ER-negative invasive carcinomas were studied. Hematoxylin-eosin-stained sections were reviewed, and new sections were stained for c-erbB-2, p53, vimentin, and androgen and prolactin receptors. The findings were correlated with the axillary lymph node status as a measure of tumor aggressiveness. SETTING: The histopathology department of a tertiary referral teaching hospital. RESULTS: The tumors included 50 (68%) invasive ductal carcinomas, 21 (28%) medullary/atypical medullary carcinomas, and 1 each of invasive lobular, apocrine, and papillary carcinoma. Some of the invasive ductal cases had distinctive features that are described in this report. Maximum tumor diameter varied between 5 and 100 mm. Sixty tumors (81%) were grade 3, 13 (18%) were grade 2, and 1 (1%) was grade 1. Of the 60 cases in which the axillary node status was known, 34 (57%) had metastases, and 26 did not. Tumors associated with positive nodes were significantly larger than those associated with negative nodes (37.2 vs 17.8 mm, P <.001). A higher percentage of node-negative tumors were c-erbB-2 positive (42% vs 21%, P <.05). There were no differences between the 2 groups with regard to histologic type, tumor grade, or the expression of p53, vimentin, or androgen or prolactin receptors. CONCLUSIONS: Many ER-negative breast carcinomas have distinctive microscopic features. Not all ER-negative tumors are aggressive, as judged by the absence of lymph node metastases in 43% of cases in this series. Tumor size is the most important indicator for the likelihood of the presence of lymph node metastases. The wide range of tumor sizes encountered in this series suggests that the ER status of a tumor is determined early in its natural history and supports the existence of 2 separate pathways for the development of ER-negative and ER-positive breast carcinomas.     

胃癌P-糖蛋白和p53蛋白协同表达的意义

目的：探讨P糖蛋白和p53蛋白在胃癌中的协同表达意义。方法：应用免疫组化方法检测259例术前未进行化疗的胃癌组织中多药耐药基因产物P 糖蛋白的表达。结果：P－gp和p53在胃癌中的表达分别为26．25％（68／259）和37．01％（96／259）。P－gp表达与胃癌的组织学类型、浸润深度和淋巴结转移状况无关（P＞0．05）;p53除与淋巴结转移状况有关外（P＜0．001）,与组织学类型和浸润深度无关（P＞0．05）。P-gp在p53阳性的病例中的表达明显高于p53阴性的病例,即75％P－gp阳性的病人同时伴有p53阳性。结论：P-gp和p53常协同表达于胃癌组织中,并可作为胃癌病人预后判断和临床耐药的一个可靠指标。     

Reduced expression of the cell-cycle inhibitor p27Kip1 is associated with progression and lymph node metastasis of gastric carcinoma

AIMS: p27Kip1 (p27), a cyclin-dependent kinase inhibitor, plays an important role as inhibiting the progression of the cell cycle. Decreased expression of p27 is associated with high histological grade and aggressiveness of several human tumours. We aimed to evaluate the role of p27 in the progression and metastasis of gastric carcinoma. METHODS AND RESULTS: We analysed the expression of p27 in 67 primary gastric carcinomas and 31 lymph node metastases by immunohistochemistry. Reduced expression of p27 was found more frequently in advanced gastric cancer (40.9%) than in early gastric cancer (15.6%) (P < 0.001). Decreased p27 expression correlated with large tumour size, high histological grade, lymphatic invasion, advanced stage, deep invasion, lymph node metastasis and recurrence. The expression of p27 showed an inverse correlation with the Ki67 labelling index. There was a significant reduction of p27 expression in metastatic tumour cells in lymph nodes (mean positive cells: 3. 7%) when compared to the corresponding primary gastric carcinomas (mean positive cells: 8.1%) (P = 0.008). CONCLUSIONS: Alterations of p27 expression may play an important role in the progression and metastasis to lymph node of tumour cells in human gastric carcinoma.     

Pathological prognostic factors in breast cancer. IV: Should you be a typer or a grader? A comparative study of two histological prognostic features in operable breast carcinoma

In a study of 1529 patients with primary operable breast carcinoma we have assessed the effect of applying both histological grade and tumour type to determine their comparative value as prognostic factors in human breast cancer. The prognostic group the patient was placed in, based on histological type alone, was less accurate than using grade and type together for many tumours. The importance of performing histological grading of ductal/no special type carcinoma (50% of the women in this series) is confirmed in this series. The 10-year-survival varied from 76% for women with grade 1 carcinoma to 39% for those with grade 3 tumours. Some of the 'special types' of breast carcinoma including tubular, tubulo-lobular, invasive cribriform and grade 1 mucinous carcinomas behaved as would be predicted, with a greater than 80% 10-year-survival in this series. Others, including grade 2 mucinous carcinomas, however, behaved less well with a 60% to 80% 10-year-survival. Indeed, many of the histological tumour types including tubular mixed, ductal/no special type, mixed ductal with special type and lobular carcinomas of classical, solid or mixed types showed a variation in behaviour that could not be predicted by typing alone. Histological grade and tumour type, when used together, more accurately predicted prognosis. In multivariate analysis of a larger group of 2658 cases of primary breast carcinomas (including the 1529 study cases) when histological grade, lymph node status and tumour size were entered, grade was the most important factor in predicting for survival. When histological type of carcinoma was included it was also found to be independently significant, although comparatively of less importance than grade. We conclude that tumours should be typed and graded in order to predict prognosis most accurately and to enable the choice of optimum treatment for women with primary breast carcinoma.     

葡萄糖转运蛋白1、人类血管内皮生长因子C、核因子κB在乳腺浸润性导管癌组织中的表达及其对患者预后的影响

目的 探讨葡萄糖转运蛋白1(GLUT-1)、人类血管内皮生长因子C(VEGF-C)、核因子κB(NF-κB)在乳腺浸润性导管癌组织中的表达及其对患者预后的影响。方法 回顾性研究。纳入2011年1月-2014年11月蚌埠市第三人民医院117例乳腺浸润性导管癌患者(年龄20~79岁)的临床资料及癌组织病理学标本,并随机采集其中51例患者的癌旁组织标本。以免疫组织化学法检测标本中GLUT-1、VEGF-C、NF-κB的表达,比较其在癌组织和癌旁组织中表达量的差异,分析阳性表达与浸润性导管癌临床病理因素的关系,及其对临床预后的影响。结果 GLUT-1、NF-κB、VEGF-C在浸润性导管癌组织中阳性表达率高于癌旁组织,差异均有统计学意义(χ²=45.785、48.433、48.236, P值均<0.01)。GLUT-1、NF-κB、VEGF-C在不同肿瘤大小、有无淋巴浸润、不同TNM分期和病理分级患者阳性表达率的差异均有统计学意义(P值均<0.05)。117例浸润性导管癌患者中,失访7例,死亡32例。110例随访的乳腺浸润性导管癌患者中,GLUT-1阳性表达患者的5年生存率(21.82%)显著低于阴性表达患者(77.09%),差异有统计学意义(χ²=10.854,P<0.01);NF-κB、VEGF-C阳性表达与阴性表达患者5年生存率差异均无统计学意义(χ²=0.843、0.852,P值均>0.05)。结论 GLUT-1、VEGF-C、NF-κB表达升高可能参与了乳腺浸润性导管癌的侵袭进展过程,其中GLUT-1是影响患者预后的高风险因素。     

肿瘤间质比和肿瘤浸润淋巴细胞对淋巴结转移乳腺癌预后的影响

目的探讨肿瘤间质比(tumor-stroma ratio,TSR)和肿瘤浸润淋巴细胞(tumor-infiltrating lymphocytes,TIL)对淋巴结阳性非特殊型浸润性乳腺癌预后的影响。方法采用HE染色法评估260例乳腺原发癌和相应淋巴结转移癌中TSR和原发癌中的TIL对患者预后的影响。结果乳腺原发癌中TSR≥50%(低间质组)148例,TSR<50%(高间质组)112例,低间质组患者总生存率和无瘤生存率明显高于高间质组(P均<0.05);TIL低表达组(TIL<10%)155例,高表达组(TIL≥10%)105例,两组患者总生存率和无瘤生存率差异无统计学意义(P均>0.05)。淋巴结转移癌中TSR≥50%(低间质组)163例,TSR<50%(高间质组)97例,低间质组患者无瘤生存率明显高于高间质组(P<0.05);原发癌和淋巴结转移癌同为低间质组时,原发癌低间质组提示预后更好(P<0.05)。原发癌与淋巴结转移癌中TSR呈明显的正相关(r=0.726,P<0.01)。原发癌低间质组中TIL的表达对预后影响,差异无统计学意义(P均>0.05);高间质组中TIL高表达组无瘤生存率明显高于TIL低表达组(P=0.012)。患者总生存率和无瘤生存率与年龄、肿块直径、组织学分级和阳性淋巴结个数无关(P均>0.05)。结论TSR是判断淋巴结转移的乳腺癌患者预后重要指标,且在原发癌和转移癌之间呈正相关,但原发癌TSR对判断预后更有意义。联合TSR和TIL分析,可为淋巴结阳性的乳腺癌患者预后和临床治疗提供帮助。     

乳腺浸润性微乳头状癌的病理学特征与淋巴结转移的关系

目的研究乳腺浸润性微乳头状癌(IMPC)的病理学特征与淋巴结转移的关系。方法观察51例乳腺IMPC的主要病理学特征及淋巴结转移情况,采用免疫组织化学方法(LSAB法)检测IMPC中血管内皮生长因子(VEGF)-C和VEGF受体(R)-3的表达并计数淋巴管密度,分析其与淋巴结转移的关系。结果(1)乳腺IMPC病理组织学分级Ⅱ、Ⅲ级组的淋巴结转移数平均12.5个,明显高于Ⅰ级组的4.0个;(2)间质淋巴细胞浸润(+)和(++)组的淋巴结转移率(27/28,96.4%)明显高于(-)和(±)组(14/23,60.9%),且其淋巴结转移数平均14.4个,也明显高于(-)和(±)组的4.6个;(3)IMPC肿瘤细胞的VEGF-C表达在病理组织学分级Ⅱ、Ⅲ级组显著高于Ⅰ级组(P=0.03),VEGF-C的表达与淋巴结转移呈正相关(P=0.006);淋巴管密度与VEGF-C表达(P=0.009)、淋巴结转移(P=0.007)呈正相关;(4)肿瘤组织中IMPC成分的多少与淋巴结转移无显著性关系,淋巴结转移灶为纯IMPC或以IMPC成分为主;(5)28例伴有导管原位癌的IMPC中,14例为微乳头状型导管原位癌(14/28,50%)。结论乳腺IMPC的病理组织学分级、淋巴管密度及间质淋巴细胞浸润可能是影响IMPC淋巴结转移的关键性因素。VEGF-C和VEGFR-3表达增高是促使IMPC发生淋巴结转移的重要原因。微乳头状型导管原位癌可能是IMPC的早期阶段。     

神经周浸润在乳腺癌中的意义

目的：对乳腺浸润性导这癌神经周浸润与肿瘤的大小、肿瘤的组织学分级、肿瘤的ＴＮＭ分期、淋巴结转移、５年存活率、肿瘤标志物ＣＥＡ等之间关系进行探讨。方法：６５例乳腺浸润性导管癌组织常规取材制片,ＨＥ、Ｇｏｄｅｎ－Ｓｗｅｅｔ网染,ｌａｍｉｎｉｎ、ＣＥＡ、ｖｉｍｅｎｔｉｎＳ－Ｐ法免疫标记染色法光镜观察。结果：神经周浸润与肿瘤大小、的组织学分级、肿瘤的ＴＮＭ分期、淋巴结转移率均成正相关;与淋巴管浸润关系密切     

DEK overexpression is correlated with the clinical features of breast cancer

To investigate the clinicopathological significance of DEK overexpression in breast cancers, a total of 196 cases, including 20 of normal tissues, 12 of intraductal hyperplasia, 31 of ductal carcinoma in situ (DCIS) and 133 of invasive ductal carcinoma of the breast, were selected from the Department of Pathology, Yanbian Tumor Hospital for immunohistochemical staining of DEK, estrogen (ER), progesterone (PR) and Ki-67 proteins. In results, DEK protein had higher positivity in DCIS, compared with the adjacent normal breast tissues. Also, DEK protein was strongly positive in invasive ductal carcinoma of the breast on immunohistochemistry, which was significantly higher than normal breast tissues. However, only two (2/12) cases of intraductal hyperplasia of the breast showed positive staining for DEK protein. Additionally, DEK overexpression was significantly correlated with the increased proliferating index of Ki-67. For the histological grade, DEK positive rate was only 39.6% in G1 breast cancers, but significantly higher in G2 (92.3%) and G3 (97.0%) cases (P<0.05). Also, a strongly positive rate of DEK was lower in Stage-0 (21.4%) and Stage-I (40.9%) compared with Stage-IIa (87.5%), Stage-IIb (89.7%) and Stage-IIIa (92.3%) (P<0.05). And DEK protein showed higher expression level in < 3 years disease free survival breast cancers than it did in ≥ 3 years disease free survival cases (P<0.05). However, no statistically difference was found among DEK expression, lymph node metastasis, and ER and PR expressions. In conclusion, DEK overexpression appears to be associated with breast cancer progression and DEK may potentially be used as a breast cancer biomarker for the early diagnosis, prognostic evaluation and therapeutic target for breast cancer.