PLK1在乳腺癌分子亚型中的表达及其与基底细胞样型乳腺癌的关系

目的:探讨乳腺癌各分子亚型中PLK1的表达及其与基底细胞样型乳腺癌的关系.方法:回顾性分析803例乳腺浸润性导管癌的临床病理资料,按照Nielsen标准将乳腺浸润性导管癌分成腺腔A型、腺腔B型、HER-2过表达型、基底细胞样型和普通乳腺样型.检测PLK1在5种不同乳腺癌亚型中的表达水平并分析其与基底细胞样型乳腺癌的关系.结果:PLK1在基底细胞样型、普通乳腺样型、HER-2过表达型、腺腔A型及腺腔B型乳腺癌中的阳性表达率分别为58.94%(56/95),39.39%(65/165),33.33%(22/66),17.91%(79/441)及5.56%(2/36).PLK1在ER阴性的乳腺癌分子亚型中的表达显著高于其在ER阳性的乳腺癌分子亚型中的表达,差异具有统计学意义(P<0.05);PLK1的表达与ER呈负相关,与Ki-67表达呈正相关(P<0.01),与HER-2无显著相关性.ER阴性乳腺癌中,PLK1在基底细胞样型乳腺癌中的阳性表达率最高,显著高于其在HER-2过表达型及普通乳腺样型乳腺癌中的表达,差异有统计学意义(P<0.05).而HER-2过表达型与普通乳腺样型中相比,PLK1的表达差异无统计学意义(P=0.390).PLK1的表达与基底细胞样型乳腺癌的淋巴结转移及临床分期相关,而与肿瘤大小及患者年龄无关.结论:PLK1过表达可能与ER阴性的基底细胞样型乳腺癌关系更密切,并在基底细胞样型乳腺的浸润、转移中起重要作用.     

乳腺癌分子亚型中BRCA1的表达及其与雌激素受体的关系

目的 研究BRCA1在乳腺癌分子亚型中表达特点及其与雌激素受体的关系.方法 1 452例乳腺癌标本制作组织芯片,免疫组织化学MaxVision快捷法检测ER、PR、HER2、CK5/6、EGFR的表达,按照Nielsen标准进行分子分型.免疫组织化学MaxVision快捷法检测BRCA1的表达水平.结果 腺腔A型,腺腔B型,基底样型,HER2过表达型和裸表达型分别为428例、56例、223例、188例、416例.BRCA1在腺腔A型,腺腔B型,基底样型,HER2过表达型,裸表达型中的表达率分别86.9%(358/412), 87.5%(49/56), 63.0%(136/216), 70.4%(131/186), 60.4%(246/407).BRCA1在基底样型乳腺癌、HER2过表达型和裸表达型中的表达率低于ER阳性乳腺癌腺腔A型(P<0.001)和腺腔B型(P<0.001),BRCA1的阳性表达与ER的阳性表达相关(P<0.001).结论 BRCA1在基底样型乳腺癌和其他ER阴性乳腺癌亚型中的表达下调,其功能异常可能参与ER阴性乳腺癌分子亚型的发生.     

乳腺癌不同分子亚型中Wnt/β-catenin信号传导通路的异常表达

目的检测Wnt信号通路的关键组分β-catenin蛋白在管腔A、管腔B、HER-2过表达、基底细胞样及未分类型(基底细胞样及未分类型统称为三阴型)乳腺癌中的表达及细胞内定位,及其与乳腺癌临床病理参数的关系。方法采用免疫组化Eli Vison两步法检测58例乳腺癌中β-catenin蛋白表达及细胞内定位。结果 (1)管腔A、管腔B、HER-2过表达、基底细胞样及未分类型乳腺癌中β-catenin胞质异常表达阳性率分别为21.1%、50%、60%、100%及60%(三阴型84.6%),差异有显著性(P<0.01)。β-catenin高胞质表达与基底细胞样及三阴型乳腺癌相关(P<0.05)。(2)β-catenin胞质异常表达与组织学分级相关(P<0.01),与淋巴结转移、肿瘤大小、患者年龄无关;与E-cadherin膜表达缺失、Ki-67及CK5/6表达呈正相关(P<0.05),与ER及PR表达呈负相关(P<0.01)。结论乳腺癌中Wnt信号通路的异常与组织学分级、Ki-67及CK5/6表达呈正相关,与ER、PR表达呈负相关。基底细胞样及三阴型分子亚型有更高频率的Wnt信号异常。β-catenin有可能成为基底细胞样及三阴型乳腺癌的治疗靶点。     

基底细胞样型乳腺癌中CAIX的表达及临床意义

目的 探讨碳酸酐酶IX(carbonic anhydrase IX,CAIX)在基底细胞样型乳腺癌(basal-like breast carcinomas,BLBCs)中的表达,分析其与乳腺癌患者相关临床病理指标的关系.方法 应用免疫组化SP法检测CAIX在45例BLBCs、25例非基底细胞样型乳腺癌(non- basal-like breast carcinomas,non-BLBCs)和10例正常乳腺组织中的表达.结果 免疫组化检测结果显示,CAIX在BLBCs组织中的阳性表达率明显高于non-BLBCs和正常乳腺组织(P<0.05);BLBCs组织中CAIX的表达与肿瘤直径(P=0.001)、pTNM分期(P=0.014)及淋巴结转移(P=0.006)均呈正相关(P<0.05).结论 CAIX在BLBCs中高表达,提示其可能参与该型乳腺癌病程进展的重要分子;CAIX的表达与多项临床病理指标、尤其是淋巴结转移密切相关,提示其可作为预测BLBCs淋巴结转移及预后的指标.     

乳腺癌细胞核形态定量分析与临床病理特征的关系

目的：观察乳腺癌细胞核形态参数,探讨其与ER、PR、HER-2表达和临床病理特征的关系。方法收集388例乳腺癌标本,根据ER、PR和HER-2三种抗体的免疫组化标记结果,将乳腺癌分为管腔A( Luminal A)型、管腔B( Luminal B)型、HER-2过表达型和基底细胞样( Basal-like)型,各组行HE染色后通过图像分析软件测量细胞核参数,应用统计学分析各组间的差异,并通过电话或住院病例随访。结果各组乳腺癌细胞核等圆直径、面积及边缘周长差异有统计学意义( P均<0.05);ER+/PR+病例细胞核形态定量与ER-/PR-病例比较,差异有统计学意义( P<0.05);ER-/PR-病例组织学分级多为Ⅲ级,生存率低于ER+/PR+病例(P<0.05)。 Luminal A型乳腺癌的无病生存期高于Basal-like型(P<0.05),总生存期高于HER-2过表达型(P<0.05)和Basal-like型(P<0.05)。结论乳腺癌细胞核形态定量差异有显著性,对其分子分型有一定的参考价值。 ER、PR和HER-2免疫组化标记结合细胞核形态学测量结果对乳腺癌的治疗和预后的评估有重要意义。     

PTEN和p27在乳腺癌分子亚型中的表达及其相关性

目的探讨PTEN、p27在乳腺癌分子亚型中的表达情况,并分析在基底样乳腺癌中的相关性。方法根据Nielsen标准进行分子分型的1 311例乳腺癌组织芯片,用免疫组织化学MaxVision快捷法分别检测PTEN、p27蛋白的表达水平,用原位杂交检测PTEN的mRNA的表达水平。结果在基底样型、HER2过表达、裸表达型、腺腔A型、腺腔B型中,PTEN蛋白表达率为38.9%、44.3%、30.5%、60.2%、68.6%;p27蛋白表达率为35.2%、46.3%、41.4%、55.9%和63.0%;PTEN mRNA表达率为55.9%、67.0%、55.7%、85.0%、80.0%。PTEN和p27蛋白在基底样型、HER2过表达型和裸表达型显著低于腺腔A及腺腔B型表达率(P0.05)。PTEN、p27蛋白的表达均与ER表达正相关(P0.01)。PTEN、p27蛋白的表达在基底样型乳腺癌中正相关(P0.001)。PTENmRNA阳性率ER阴性乳腺癌显著低于ER阳性乳腺癌(P0.001),PTENmRNA与蛋白表达水平显著相关(P0.001)。结论PTEN、p27的失表达可能与ER阴性乳腺癌的发生和发展有关。二者基因在基底样型乳腺癌中相关性的研究为其发病机制的阐明提供帮助。     

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。     

乳腺癌上皮间质转化与基底细胞样表型的关系

目的 评价乳腺癌七皮间质转化(EMT)与基底细胞样型乳腺癌(BLBC)的关系.方法 依据免疫表型从458例浸润性乳腺癌中筛选出基底细胞样型、管腔A型、管腔B型和HER2过表达型共382例.免疫组织化学EnVision二步法检测FOXC-2、波形蛋白、Syndecan-1和E-cadherin在乳腺癌中表达,并分析其与BLBC的关系.结果 41例BLBC中癌细胞FOXC-2、波形蛋白和Syndecan-1的阳性率以及E-cadherin表达减弱率分别为34.1%(14/41)、43.9%(18/41)、87.7%(36/41)和63.4%(26/41).BLBC的FOXC-2和波形蛋白阳性率均高于其他亚型乳腺癌,其E-cadherin表达较其他亚型乳腺癌下降(P<0.01).BLBC肿瘤间质细胞Syndecan-1阳性率为41.5%(17/41),高于其他亚型乳腺癌(P=0.007).癌细胞FOXC-2表达与波形蛋白表达呈正相关(r=0.607,P<0.01).FOXC-2和波形蛋白阳性组腋窝淋巴结转移率分别为71.4%和66.7%,分别高于阴性组(P=0.002和P=0.001).结论 本结果显示乳腺癌中EMT与BLBC关系最密切.EMT可能是造成BLBC与其他亚型乳腺癌生物学行为差异的蕈要原因.     

乳腺浸润性导管癌分子亚型与临床病理特征及预后的关系

目的 检测乳腺浸润性导管癌的临床病理特征及特定蛋白的表达情况,对其进行分型,探讨各哑型与预后的关系.方法 采用免疫组织化学EnVision法检测128例浸润性导管癌ER、PR、HER2和CK5/6的表达,参考文献报道的免疫分型方法 对其分型,并对HER2过表达型9例进行FISH检测.结果 ER、PR、HER2和CKS/6在本组128例浸润性导管癌中的阳性表达率分别为67%(86/128)、45%(58/128)、27%(34/128)和27%(34/128),并将128例分为5种免疫哑型,管腔A型55%(70/128),管腔B型20%(25/128),HER2过表达型7%(9/128),基底细胞样型10%(13/128),无法分类型8%(11/128).FISH检测HER2过表达型9例均为HER2基因扩增.各分子亚型间预后差异具有统计学意义,管腔A型预后最好,基底细胞型预后较差.多因素分析,乳腺癌临床分期和免疫分型是独立的预后因素.月经状态在乳腺癌各免疫亚型中的分布差异有统计学意义.结论 通过检测ER、PR、HER2和CK5/6的表达可以将乳腺浸润性导管癌分成具有不同生物学行为的5个免疫亚型,对于评估预后,指导治疗具有一定的意义.     

乳腺浸润性导管癌分子亚型与临床病理特征及预后的关系

目的 检测乳腺浸润性导管癌的临床病理特征及特定蛋白的表达情况,对其进行分型,探讨各哑型与预后的关系.方法 采用免疫组织化学EnVision法检测128例浸润性导管癌ER、PR、HER2和CK5/6的表达,参考文献报道的免疫分型方法 对其分型,并对HER2过表达型9例进行FISH检测.结果 ER、PR、HER2和CKS/6在本组128例浸润性导管癌中的阳性表达率分别为67%(86/128)、45%(58/128)、27%(34/128)和27%(34/128),并将128例分为5种免疫哑型,管腔A型55%(70/128),管腔B型20%(25/128),HER2过表达型7%(9/128),基底细胞样型10%(13/128),无法分类型8%(11/128).FISH检测HER2过表达型9例均为HER2基因扩增.各分子亚型间预后差异具有统计学意义,管腔A型预后最好,基底细胞型预后较差.多因素分析,乳腺癌临床分期和免疫分型是独立的预后因素.月经状态在乳腺癌各免疫亚型中的分布差异有统计学意义.结论 通过检测ER、PR、HER2和CK5/6的表达可以将乳腺浸润性导管癌分成具有不同生物学行为的5个免疫亚型,对于评估预后,指导治疗具有一定的意义.     

基底细胞样型乳腺癌的临床病理特点和预后意义

目的 探讨中国乳腺癌人群中基底细胞样型乳腺癌(BLBC)的流行病学、临床病理特征和预后意义.方法 采用组织芯片、免疫组织化学和形态学分析等方法将1311例浸润性乳腺癌组织标本分为腺腔A型、腺腔B型、BLBC型、HER2型和不表达型,并分析BLBC的流行病学、临床病理特点.获得随访资料523例,随访2-132个月,平均65.8个月.结果 BLBC发病率17.0%(223/1311),HER2型和不表达型的发病年龄均显著低于腺腔A型,肿瘤直径显著高于腺腔A型.组织结构上,BLBC多为组织学3级,较HER2型和腺腔A型更多见瘤细胞弥漫片状分布和带状分布于坏死周围的特点;多见大块地图状坏死和中央瘢痕、推进性边缘、肿瘤内淋巴细胞浸润和高核分裂指数;细胞形态上,合体细胞和基底样细胞、鳞状细胞化生和梭形细胞化生多见于BLBC.BLBC的复发率显著高于腺腔A型和HER2型,淋巴结转移率显著低于HER2型和不表达型;其他ER阴性乳腺癌(HER2型、不表达型)之无病生存率和总生存率均显著低于腺腔A型;Cox多因素风险模型分析显示基底细胞样标记不是乳腺癌独立预后因素.结论 BLBC在中国乳腺癌人群中的发病率与大多数国外文献报道相似.该亚型乳腺癌既具有不同于非BLBC的、独特的临床病理特点,也具有与其他ER阴性乳腺癌相同的临床病理特点;其形态学上的诸多特征虽不十分特异,但可作为诊断线索提示病理医师结合免疫组织化学等检查做出正确诊断.与腺腔A型相比,BLBC与其他ER阴性乳腺癌具有较差的预后.     

Molecular subtypes of breast carcinoma in Egyptian women: clinicopathological features

Breast carcinoma may be classified into distinct molecular subtypes based on immunohistochemical markers for estrogen, progesterone and Her-2/neu receptors. The aim of the study was to identify the clinicopathological features of the molecular subtypes of breast carcinoma in our locality. A total of 274 surgically resected breast carcinomas were selected from the files of the Dr. KRZ referral pathology laboratory, Mansoura, Egypt, and the Pathology Department of Mansoura University. Molecular subtypes were classified into luminal A, luminal B, Her-2/neu-expressing and triple-negative. Clinicopathological and histological features of molecular subtypes were analyzed. Luminal A subtype was the most prevalent (41.2%), followed by triple-negative subtype (28.5%), then Her2-expressing subtype (19.4%) and luminal B subtype (13.9%). The commonest histological type was infiltrating duct carcinoma (83.2%), followed by infiltrating lobular carcinoma (9.1%) and medullary carcinoma (3.2%). The luminal A subtype was significantly correlated to low tumor grade, lower number of positive lymph nodes metastasis, absence of both necrosis and syncytial growth pattern. We concluded that the commonest molecular subtype of invasive breast carcinoma among Egyptian women is luminal subtype A, which displayed favorable features. Triple-negative subtype and medullary carcinomas are present in a ratio higher than in western countries.     

Identification of different subtypes of breast cancer using tissue microarray

Breast cancer may be classified into luminal A, luminal B, HER2+/ER-, basal-like and normal-like subtypes based on gene expression profiling or immunohistochemical (IHC) characteristics. The main aim of the present study was to classify breast cancer into molecular subtypes based on immunohistochemistry findings and correlate the subtypes with clinicopathological factors. Two hundred and seventeen primary breast carcinomas tumor tissues were immunostained for ER, PR, HER2, CK5/6, EGFR, CK8/18, p53 and Ki67 using tissue microarray technique. All subtypes were significantly associated with Malay ethnic background (p=0.035) compared to other racial origins. The most common subtypes of breast cancers were luminal A and was significantly associated with low histological grade (p<0.000) and p53 negativity (p=0.003) compared to HER2+/ER-, basal-like and normal-like subtypes with high histological grade (p<0.000) and p53 positivity (p=0.003). Luminal B subtype had the smallest mean tumor size (p=0.009) and also the highest mean number of lymph nodes positive (p=0.032) compared to other subtypes. All markers except EGFR and Ki67 were significantly associated with the subtypes. The most common histological type was infiltrating ductal carcinoma, NOS. Majority of basal-like subtype showed comedo-type necrosis (68.8%) and infiltrative margin (81.3%). Our studies suggest that IHC can be used to identify the different subtypes of breast cancer and all subtypes were significantly associated with race, mean tumor size, mean number of lymph node positive, histological grade and all immunohistochemical markers except EGFR and Ki67.     

乳腺癌分子标志和分子分型

乳腺癌是生物学高度异质性的肿瘤,雌激素受体(estrogen recept,ER)、孕激素受体(progester-one recept,PR)、人表皮生长因子受体2(human epidermal growth factor 2,HER-2)是目前预测预后和指导治疗重要的分子标志。随着分子生物学技术的不断进步,可以根据ER、PR、HER-2表达状态和细胞形态学可以将乳腺癌大致分成4至5个亚群,即Luminal(ER /PR )、HER-2 (ER-,PR-,HER-2 )、Basal-like(ER-,PR-,HER-2-)和Normal-like等,它们在临床治疗反应和生存方面截然不同。因此,对乳腺癌进行分子标志检测或分子分型有利于判断患者的临床预后和指导临床治疗。     

TopoⅡα在老年乳腺癌中的表达及其临床病理意义

目的对老年乳腺癌中TopoⅡα的表达与多个临床病理因素行相关性分析,探讨其表达的临床意义。方法应用免疫组化SP法检测南方医科大学附属南方医院近2年来所有老年乳腺癌共105例中TopoⅡα、ER、PR以及HER-2的表达情况;依据免疫组化的表达将其近似划分为LuminalA型(ER+和/或PR+,HER-2-)、LuminalB型(ER+和/或,PR+,HER-2+)、HER-2过表达型(ER-,PR-,HER-2+)和Basal-like型(ER-,PR-,HER-2-)4个分子亚型,对比TopoⅡα表达阳性率的差异。用统计学软件SPSS13.0作为统计分析的工具,TopoⅡα表达与临床病理因子的关系用卡方检验和Spearman相关分析检验。结果老年乳腺癌组织中TopoⅡα蛋白表达阳性率为62.9%,Basal-like型最高,HER-2过表达型仅次之,再次为LuminalB型,LuminalA型最低(P<0.050);阳性表达在不同组织学分期和淋巴结状态患者间差异中有统计学意义且呈正相关(P<0.050)。在不同肿瘤大小患者间差异无统计学意义。结论乳腺癌组织病理检查应根据ER、PR和HER-2的免疫组化结果行分子分型,进一步行TopoⅡα的免疫组化检测,以获得更多的预后信息,进一步指导老年乳腺癌治疗。     

The Differences in CXCR4 Protein Expression Are Significant for the Five Molecular Subtypes of Breast Cancer

The aim was to investigate the expression of the CXCR4 protein in five molecular subtypes of breast cancer. The authors randomly selected the breast cancer paraffin-embedded specimens of the Affiliated Third Hospital of Harbin Medical University between 2007 and 2009. Details are as follows: basal-like subtype—ER (–), PR (–), C-erbB-2 (–), CK5/6 (+), n = 36; normal breast subtype—ER (–), PR (–), C-erbB-2 (–), CK5/6(–), n = 40; luminal A subtype—ER/PR (+), C-erbB-2 (–), n = 38; luminal B subtype—ER/PR (+), C-erbB-2 (+), n = 60; C-erbB-2 (+) subtype—ER (–), PR (–), C-erbB-2 (+), n = 58. Using the immunohistochemistry method, the authors detected the expression of the CXCR4 protein in the five subtypes. The CXCR4 protein expression in the basal-like subtype was the highest, and that in the luminal A subtype was the lowest. In terms of five molecular subtypes of breast cancer, the differences in CXCR4 protein expression were significant (p < .001). In terms of C-erbB-2 expression, tumor stage, and lymph node metastasis of breast cancer, the differences in CXCR4 protein expression were significant (p < .01).     

Clinicopathologic significance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes

DNA microarray profiling studies have led to the classification of invasive breast carcinoma into luminal/estrogen receptor-positive, normal breast-like, Her2/neu-overexpressing, and basal-like types. Among these groups, the basal-like subtype is associated with the poorest clinical outcome in Western countries. To date, the clinicopathologic characteristics of the basal-like carcinomas, compared with other subtypes, have not been described in the Korean population. In this study, we used tissue microarray to examine the expression of basal cytokeratins (CK) (CK5 and CK14) and luminal CK (CK8/18), epidermal growth factor receptor, c-kit, hormone receptors (HRs), p53, and Her2/neu in 776 consecutive patients diagnosed with invasive breast carcinoma from January 1993 to December 1998 and categorized these cases into 5 subgroups (basal-like, HR-expressing, Her2/neu-overexpressing, HR and Her2/neu-expressing, and null subtypes negative for all markers), based on the immunohistochemical data. We identified cases of 114 (14.7%) basal-like, 345 (44.5%) HR-expressing, 133 (17.1%) Her2/neu-overexpressing, 61 (7.8%) HR and Her2/neu-expressing, and 123 (15.9%) null subtypes. Histologically, most basal-like breast cancers were invasive ductal carcinoma, not otherwise specified (98 cases, 86.0%), with high nuclear and/or histologic grades, and most metaplastic carcinomas (6 [75.0%] of 8 cases) were the basal-like subtype. Both basal-like and Her2/neu-overexpressing subtypes were associated with larger tumor sizes (mean, 3.6 and 3.3 cm, respectively) than the HR-expressing group (mean, 2.8 cm) (P = .001 and P = .036, respectively). Nodal stage of Her2/neu-overexpressing subtype was higher than that of basal-like subtype; however, overall stage was not different between the 2 groups (P = .010 and .123, respectively). Distant metastasis was most frequently observed in the Her2/neu-overexpressing subtype (33.8%), which was prognostically the worst subgroup of breast cancers. In contrast to previous findings from Western countries, our analyses reveal that the Her2/neu status is the most important prognostic factor of breast cancers.     

Identification of a basal-like subtype of breast ductal carcinoma in situ

Microarray profiling of invasive breast carcinomas has identified subtypes including luminal A, luminal B, HER2-overexpressing, and basal-like. The poor-prognosis, basal-like tumors have been immunohistochemically characterized as estrogen receptor (ER)-negative, HER2/neu-negative, and cytokeratin 5/6-positive and/or epidermal growth factor receptor (EGFR)-positive. The aim of this study was to determine the prevalence of basal-like ductal carcinoma in situ in a population-based series of cases using immunohistochemical surrogates. A total of 245 pure ductal carcinoma in situ cases from a population-based, case-control study were evaluated for histologic characteristics and immunostained for ER, HER2/neu, EGFR, cytokeratin 5/6, p53, and Ki-67. The subtypes were defined as: luminal A (ER+, HER2-), luminal B (ER+, HER2+), HER2 positive (ER-, HER2+), and basal-like (ER-, HER2-, EGFR+, and/or cytokeratin 5/6+). The prevalence of breast cancer subtypes was basal-like (n = 19 [8%]); luminal A, n = 149 (61%); luminal B, n = 23 (9%); and HER2+/ER-, n = 38 (16%). Sixteen tumors (6%) were unclassified (negative for all 4 defining markers). The basal-like subtype was associated with unfavorable prognostic variables including high-grade nuclei (P < .0001), p53 overexpression (P < .0001), and elevated Ki-67 index (P < .0001). These studies demonstrate the presence of a basal-like in situ carcinoma, a potential precursor lesion to invasive basal-like carcinoma.     

乳腺癌转移、化疗抵抗与STC1的表达情况分析

目的：考察人斯钙素1(stanniocalcin 1，STC1)表达水平与乳腺癌的转移、化疗抵抗等病理参数相关性。方法：采用免疫组织化学法分析76例乳腺癌组织中STC1蛋白表达水平，并比较其表达水平和癌症转移、化疗抵抗等病理参数关系。结果：在76例乳腺癌组织中STC1阳性表达33例、阴性表达43例。两组间年龄、肿块直径、分期差异无统计学意义(P>0.05)，但两组间乳腺癌的转移率和化疗抵抗发生率差异具有统计学意义(P<0.05)。Pearson相关系数检验证实STC1表达水平与转移率和化疗抵抗发生率正相关(r=0.413；r=0.359)。结论：人斯钙素1的表达与乳腺癌组织的转移、化疗抵抗相关，是预后预测的参考指标。