间质CD10和Ezrin在乳腺癌中的表达及其意义

目的 观察间质CD10和Ezrin在乳腺导管内癌及浸润性导管癌中的表达,探讨两者在乳腺癌发展中的作用.方法 采用免疫组织化学SP法测定60例导管内癌及60例浸润性导管癌中间质CD10和Ezrin的表达.结果 间质CD10的表达在浸润性导管癌中为阴性25例、弱阳性18例、强阳性17例,导管内癌中分别为36例、18例、6例,其在浸润性导管癌中的表达水平高于在导管内癌中的表达水平(Z=-2.465,P<0.05).Ezrin在导管内癌组的定位为癌细胞腔面15例(P>0.05).结论 间质CD10表达的增加和Ezrin在癌细胞内亚定位的改变可能促进乳腺导管内癌浸润的发生.     

间质CD10和Ezrin在乳腺癌中的表达及其意义

目的 观察间质CD10和Ezrin在乳腺导管内癌及浸润性导管癌中的表达,探讨两者在乳腺癌发展中的作用.方法 采用免疫组织化学SP法测定60例导管内癌及60例浸润性导管癌中间质CD10和Ezrin的表达.结果 间质CD10的表达在浸润性导管癌中为阴性25例、弱阳性18例、强阳性17例,导管内癌中分别为36例、18例、6例,其在浸润性导管癌中的表达水平高于在导管内癌中的表达水平(Z=-2.465,P<0.05).Ezrin在导管内癌组的定位为癌细胞腔面15例(P>0.05).结论 间质CD10表达的增加和Ezrin在癌细胞内亚定位的改变可能促进乳腺导管内癌浸润的发生.     

印迹基因SLC22A18在乳腺癌中的表达及其意义

目的 研究印迹基因SLC22A18在乳腺浸润性导管癌中mRNA和蛋白水平的表达.并分析SLC22A18表达与乳腺癌临床病理特征之间的相关性,从而探讨SLC22A18基因在乳腺癌发生发展中的作用.方法 应用实时荧光定量逆转录聚合酶链反应方法检测46例乳腺浸润性导管癌和对应癌旁乳腺组织,以及20例乳腺良性病变组织中SLC22A18 mRNA的表达,应用免疫组织化学方法检测46例乳腺浸润性导管癌组织、20例乳腺良性病变中SLC22A18蛋白表达,分析SLC22A18 mRNA和蛋白表达与乳腺癌临床病理特征间的关系.结果 SLC22A18在46例乳腺浸润性导管癌中mBNA表达量低于癌旁组织(Z=-4.900,P＜0.01);46例乳腺浸润性导管癌中SLC22A18 mRNA表达量低于乳腺良性病变(Z=-3.182,P＜0.01).40例乳腺浸润性导管癌中SLC22A18 mRNA表达量低于6例导管内癌灶性浸润(Z=-2.022,P＜0.05).SLC22A18蛋白在20例乳腺良性病变、46例乳腺浸润性导管癌中表达阳性率分别为95%、69.6%,两组阳性表达率差异有统计学意义(x2=5.135,P＜0.05).SLC22A18 mRNA和蛋白表达与患者年龄、肿瘤大小、组织学分级、TNM分期及淋巴结转移均无相关性(P＞0.05).结论 SLC22A18在乳腺浸润性导管癌中表达下调,SLC22A18可能参与了乳腺癌的发生,并有可能成为乳腺癌早期诊断的新分子标志物.     

端粒酶逆转录酶、环氧化酶-2在乳腺癌中的表达及其意义

目的 探讨端粒酶逆转录酶(hTERT)和环氧化酶(cox)-2在乳腺浸润性导管癌中的表达及其临床意义.方法 使用免疫组织化学法分别检测45例乳腺浸润性导管癌和22例乳腺良性病变标本的hTERT和COX-2蛋白表达情况.结果 hTERT在乳腺浸润性导管癌中阳性表达率fig71.11%,明显高于乳腺良性病变9.09%,两者比较差异有统计学意义(P<0.05).hTERT阳性表达与乳腺浸润性导管癌患者的年龄、肿瘤大小、腋窝淋巴结转移情况及雌、孕激素表达水平无相关性(P>0.05),与Her-2表达存在显著相关性(P<0.05).COX-2在乳腺浸润性导管癌中的阳性表达率为82.22%,明显高于乳腺良性病变50.00%,两者比较差异有统计学意义(P<0.05).COX-2阳性表达与乳腺浸润性导管癌患者腋窝淋巴结转移情况、Her-2、ER阳性表达有关(P<0.05).在乳腺浸润性导管癌中hTERT阳性表达与COX-2阳性表达呈正相关(r=0.557,P<0.01).结论 hTERT与COX-2在乳腺浸润性导管癌中的表达显著高于在乳腺良性病变中的表达,hTERT与COX-2在乳腺癌的发生、发展中起重要作用.hTERT表达与COX-2表达存在显著相关性,COX-2的过度表达可能是端粒酶激活和调节的机制之一.     

ALCAM/CD166在乳腺癌组织中表达及意义以及其与Bcl-2、Ki-67的关系

目的研究乳腺浸润性导管癌组织中活化白细胞黏附分子(ALCAM/CD166)的表达及其与凋亡抑制蛋白Bcl-2及增殖细胞核抗原Ki-67的关系,探讨ALCAM/CD166在乳腺浸润性导管癌发生、发展中的作用。方法应用免疫组织化学Elivision~(TM) Plus二步法检测96例乳腺浸润性导管癌组织和30例癌旁非瘤乳腺上皮组织中ALCAM/CD166及Bcl-2、Ki-67蛋白表达的情况,分析ALCAM/CD166蛋白表达与乳腺浸润性导管癌患者的年龄、肿瘤直径、组织病理学分级、淋巴结转移及TNM分期的关系以及其与Bcl-2、Ki-67的相关性。结果 1在96例乳腺浸润性导管癌中ALCAM/CD166蛋白表达阳性率为79.2%(76/96),明显高于其在癌旁非瘤乳腺上皮组织中的10.0%(3/30),差异有统计学意义(P0.01)。2 ALCAM/CD166蛋白阳性表达与乳腺浸润性导管癌患者的年龄、肿瘤直径、组织病理学分级及TNM分期均无关(P0.05),与腋窝淋巴结转移有关(P0.05)。3乳腺浸润性导管癌组织中ALCAM/CD166蛋白表达与Bcl-2蛋白表达呈正相关(rs=0.307,P=0.001),而与Ki-67蛋白表达无关(rs=0.064,P=0.475)。结论 ALCAM/CD166蛋白表达与乳腺浸润性导管癌细胞凋亡及转移有关,可能成为判断肿瘤生物学行为和患者预后的重要参考指标之一。     

Slit2在乳腺组织的表达与乳腺癌脑转移的关系

目的 检测神经轴突导向蛋白2(Slit2)在不同乳腺肿瘤组织中的表达,探讨Slit2与乳腺癌脑转移的相关性.方法 采用免疫组织化学LSAB法检测对24例发生脑转移的乳腺浸润性导管癌(IDC)、71例未发生脑转移的乳腺浸润性导管癌、22例乳腺导管内癌和23例乳腺腺纤维瘤组织中Slit2的表达.结果 Slit2在浸润性导管癌中有脑转移患者的阳性表达率(13%)明显低于无脑转移患者(59%)(P＜0.05);在乳腺导管内癌和浸润性导管癌中的阳性表达率(59%和48%)均明显低于乳腺纤维瘤(87%,P＜0.05);但前两者间差异无统计学意义(P＞0.05);在50岁以上乳腺癌患者中的阳性表达率(62%)明显高于50岁及以下患者(34%,P＜0.05);在生存期＜5年的乳腺浸润性导管癌患者组织中Slit2的阳性表达率(18%)明显低于生存期＞5年的患者(59%)(P＜0.05).Slit2阴性的患者总生存时间明显短于Slit2阳性患者(P＜0.01).Slit2在乳腺癌中的表达与肿瘤大小、淋巴结转移状态、病理学分期、组织学分级均无明显相关(P＞0.05).结论 乳腺癌中Slit2的表达和乳腺癌脑转移呈负相关,和乳腺浸润性导管癌患者的发病年龄及预后呈正相关,可成为判断乳腺癌预后和脑转移的分子标志物.     

中心体β-微管蛋白在乳腺癌前病变及其乳腺癌中的表达和意义

目的 探讨中心体β-微管蛋白在人乳腺癌前病变和乳腺癌中的表达及其意义.方法 采用免疫组织化学SP法检测乳腺癌前病变、导管内癌和浸润性导管癌各50例中中心体β-微管蛋白的表达水平,30例乳腺正常组织作为对照组.结果 不同样本组中心体β-微管蛋白的表达水平不同(χ2=25.381,P《0.05),其在导管内癌组和浸润性导管癌组间的差异无统计学意义(z=-0.909,P》0.05),其他各组间均有统计学意义(P《0.05).此外,中心体β-微管蛋白表达水平与乳腺导管内癌的核分级、浸润性导管癌的组织学分级之间无明显相关(P》0.05),但与浸润性导管癌的腋淋巴结转移呈正相关(r=0.285,P《0.05).结论 中心体的异常可能是乳腺癌发生的早期事件,并促进肿瘤的发生发展.研究β-微管蛋白的表达情况可能成为探索乳腺癌发生发展机制的一条新的途径.     

COX-2、VEGF和E-cad在乳腺癌组织中的表达及临床病理意义

目的：探讨环氧化酶-2（COX-2）、血管内皮生长因子（VEGF）和E-钙黏附蛋白（E-cad）在乳腺癌组织中的表达及与临床病理特征之间的关系。方法：应用免疫组化S-P法检测30例乳腺单纯性增生、30例乳腺导管内癌、70例乳腺浸润性导管癌组织中COX-2、VEGF和E-cad的表达情况。结果：COX-2在乳腺单纯性增生、乳腺导管内癌、乳腺浸润性导管癌组织中的表达率分别为10.0%、46.6%、72.8%,乳腺单纯性增生与乳腺导管内癌、乳腺浸润性导管癌差异均有统计学意义（P〈0.01）;乳腺导管内癌与乳腺浸润性导管癌差异有统计学意义（P〈0.05）。VEGF在乳腺单纯性增生、乳腺导管内癌、乳腺浸润性导管癌组织中的表达率分别为3.3%、50.0%、65.7%,乳腺单纯性增生与乳腺导管内癌、乳腺浸润性导管癌相比差异均有统计学意义（P〈0.01）;乳腺导管内癌与乳腺浸润性导管癌差异无统计学意义（P〉0.05）。E-cad在乳腺单纯性增生、乳腺导管内癌、乳腺浸润性导管癌组织中的表达率分别为93.3%、43.30%、32.8%,乳腺单纯性增生与乳腺导管内癌、乳腺浸润性导管癌差异均有统计学意义（P〈0.01）;乳腺导管内癌与乳腺浸润性导管癌差异无统计学意义（P〉0.05）。COX-2在乳腺浸润性导管癌的阳性表达与淋巴结转移有关（P〈0.05）,与年龄、肿瘤大小、组织学分级无关（P〉0.05）。VEGF、E-cad在乳腺浸润性导管癌的阳性表达与组织学分级、淋巴结转移密切相关,与年龄、肿瘤大小无关。COX-2、VEGF在乳腺浸润性导管癌中的表达呈正相关（R=0.44,P〈0.01）,COX-2在乳腺浸润性导管癌中的表达与E-cad的表达呈负相关（R=-0.26,P〈0.05）。结论：COX-2、VEGF的高表达及E-cad的低表达在乳腺癌的发生发展过程中起重要的作用,检测其表达异常对判断临床进展、推测预后以及制定针对性的治疗方案有一定的参考价值。     

乳腺癌发生与演进过程中血管生成作用的评价

目的 探讨人乳腺癌前病变、原位癌及浸润性癌中CD34、血管内皮生长因子(VEGF)及其受体Flk-1/KDR的表达变化及血管生成异常与乳腺癌发生发展的关系.方法 应用免疫组织化学技术检测30例正常乳腺、30例普通性增生、30例非典型增生(AH)、20例导管内癌、50例浸润性导管癌组织中微血管密度(MVD)、VEGF及Flk-1/KDR的表达.结果 各组CD34、VEGF及Flk-1/KDR的表达程度不同,浸润性导管癌组最高.随病程演进MVD逐渐增加(P<0.05),VEGF及其受体Flk.1/KDR在血管内皮细胞表达渐进性增高(P<0.05),但在病程初期各主要指标改变不明显,显著变化始于AH阶段.MVD在AH与导管内癌组间差异无统计学意义(P>0.05),VEGF及Flk-1/KDR的表达在AH与导管内癌组间差异有统计学意义(P<0.05).结论 血管生成异常可能是乳腺癌发生过程中的早期事件.VEGF及Flk-1/KDR的表达异常可能是乳腺普通性增生-AH-乳腺癌这一癌性转化过程中血管生成异常的主要始动因素,其可能成为乳腺癌早期诊治的靶标.     

CD24在乳腺浸润性导管癌中的表达及临床意义

目的:研究CD24在乳腺浸润性导管癌组织不同模式中的表达及其与临床病理因素的相关性。方法:用SP免疫组化染色法检测13例乳腺纤维腺瘤及46例乳腺浸润性导管癌组织中CD24的表达。结果: 浸润性乳腺导管癌组织中CD24在细胞膜和细胞浆都有表达，阳性率为80.43%；乳腺纤维腺瘤CD24仅在细胞膜上局灶性表达，阳性率为53.85%。CD24在浸润性导管癌中的表达浓度明显高于纤维腺瘤(P＜0.05)；并与腋窝淋巴结转移正相关(P＜0.05)；CD24细胞膜表达与雌、孕激素受体阳性表达密切相关(P＜0.001)，而与患者年龄、肿瘤大小、肿瘤分期、分级、Her 2及p53等因素无相关性（P＞0.05）。结论:CD24高表达参与乳腺癌的侵袭与转移，CD24细胞膜表达可能与乳腺癌内分泌治疗抵抗作用相关，CD24可作为乳腺不良预后的判断指标之一。     

Infiltrating ductal carcinoma and ductal carcinoma in situ associated with mammary hamartoma

Mammary hamartoma is a rare nonmalignant lesion. Only 11 cases of carcinoma associated with hamartoma have been previously described in the literature. We describe a case of infiltrating ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) associated with hamartoma in a 35-year-old woman. Mammography showed the features of a typical hamartoma with suspicious microcalcifications arising in it. The patient underwent a radical modified mastectomy. It is likely that hamartoma is a coincidental finding. The identification of suspicious microcalcifications in a typical mammographic image of a hamartoma should prompt continued examination to exclude an underlying tumor.     

Outcome after invasive recurrence in patients with ductal carcinoma in situ of the breast

BACKGROUND: Local recurrence is used as a marker of treatment failure for patients with ductal carcinoma in situ (DCIS). As follow-up lengthens, distant recurrence, breast cancer-specific survival (BCSS), and overall survival must be monitored. METHODS: A prospective database was used to analyze 1031 patients with DCIS. Patients having invasive recurrence after DCIS treatment were compared with patients having infiltrating ductal carcinoma (IDC). End points included distant recurrence, BCSS, and overall survival. RESULTS: Overall, patients with DCIS had a BCSS of 99%. BCSS was 85% for patients with invasive recurrences. DDFS in this group was 80%. Stage I IDC patients had a BCSS of 91%, whereas it was 38% in those with stage I IDC and invasive recurrences. CONCLUSIONS: Most patients with DCIS that recur can be salvaged. For the small subgroup of patients who recur with invasive breast cancer, survival is similar to that of patients with stage IIA IDC.     

Predictors of invasion and axillary lymph node metastasis in patients with a core biopsy diagnosis of ductal carcinoma in situ: an analysis of 255 cases

The diagnosis of ductal carcinoma in situ (DCIS) using core biopsy does not ensure the absence of invasion on final excision. We performed a retrospective analysis of 255 patients with DCIS who had subsequent excision. Clinical, radiologic, and pathologic findings were correlated with risk of invasion and sentinel lymph node (SLN) metastasis. Of 255 patients with DCIS, 199 had definitive surgery and 52 (26%) had invasive ductal carcinoma (IDC) on final excision. Extent of abnormal microcalcification on mammography, and presence of a radiologic/palpable mass and solid type of DCIS were significantly associated with invasion on final excision. Sentinel lymph node biopsy was performed in 131 (65.8%) patients of whom 18 (13.4%) had metastasis. Size of IDC and extent of DCIS on final pathology were significantly associated with positive SLN. Micrometastasis and isolated tumor cells comprised majority (71.4%) of the metastases in DCIS. SLN biopsy should be considered in those with high risk DCIS.     

乳腺浸润性导管/小叶混合癌与浸润性小叶癌、导管癌的临床病理特征及预后差异

目的 研究乳腺浸润性导管/小叶混合癌(infiltrative ductal/lobular mixed carcinoma,IDC-L)与浸润性小叶癌(infiltrative lobular carcinoma,ILC)及浸润性导管癌(infiltrative ductal carcinoma,IDC)病理特征及预...     

Distribution of hsp-27 and HER-2/neu in in situ and invasive ductal breast carcinomas

Background: The overexpression of heat shock protein 27 (hsp-27) in early-stage breast cancer is associated with histopathologic features of poor prognosis and clinically with an increased probability of disease recurrence. Hsp-27 is overexpressed in 25% of invasive ductal carcinomas (IDC); however, its distribution in ductal carcinoma in situ (DCIS) and DCIS associated with IDC has not been investigated. We postulated that hsp-27 might be detected and variably expressed in DCIS and, like HER-2/neu oncoprotein expression, might be a tumor-specific marker worthy of future clinical investigation. Methods: To test these hypotheses, the distribution of hsp-27 in noncomedo and comedo DCIS, and DCIS associated with IDC, was evaluated by immunohistochemistry and compared with HER-2/neu expression within the same cancers. Results: Hsp-27 was overexpressed in 28 of 47 (60%) cases of DCIS; expression in pure DCIS was 16 of 24 (67%), and 12 of 23 (50%) in DCIS associated with IDC. Hsp-27 expression by in situ and invasive components of the same neoplasm were concordant in 22 of 23 (95%) cases tested. Comedo variants appeared to have somewhat higher hsp-27 expression than noncomedo DCIS, whether or not there was an associated IDC. These results are reminiscent of HER-2/neu oncoprotein expression in DCIS and DCIS associated with IDC observed by others. However, although 4 of 22 (18%) cancers containing DCIS + IDC expressed HER-2/neu, no relationship with hsp-27 expression in the same cancers was observed. Conclusions: We found a high incidence of hsp-27 overexpression in DCIS and in DCIS associated with IDC. This rate is twice that previously observed in IDC alone. Hsp-27 expression is independent of HER-2/neu expression.     

p53 overexpression is a predictor of local recurrence after treatment for both in situ and invasive ductal carcinoma of the breast

BACKGROUND: Several biological markers have been related to prognosis in mammary ductal carcinoma. The aim of the study was to determine biological markers that could predict local recurrence following treatment for all stages of primary operable ductal carcinoma of the breast. MATERIALS AND METHODS: A consecutive series of patients treated for pure ductal carcinoma in situ (DCIS, n = 110) and invasive ductal carcinoma (IDC, n = 243) was studied. Twenty-three patients with DCIS were excluded because of lack of original paraffin embedded tissue. All patients had been treated between July 1996 and December 2001. Median follow-up was 49.8 mo. From the original paraffin embedded tumors, tissue microarrays (TMAs) were constructed. On these TMAs, immunohistochemistry was performed for estrogen-receptor (ER), progesterone-receptor (PR), Her2/neu, p53, and cyclin D1. Main outcome was the event of LR. All analyses were stratified for diagnosis (DCIS or IDC) and pathological grade. RESULTS: In univariate analyses, Her2/neu overexpression (hazard ratio [HR] 3.1, 95% confidence interval [CI] 1.1-8.7, P = 0.032) and p53 overexpression (HR 3.5, 95% CI 1.3-9.3, P = 0.014) were associated with LR in patients treated for both DCIS and IDC. In multivariate analysis, p53 overexpression (HR 3.0, 95% CI 1.1-8.2, P = 0.036 and HR 4.4, 95% CI 1.5-12.9, P = 0.008) and adjuvant radiotherapy (HR 0.2, 95% CI 0.1-0.8, P = 0.026) were independent common predictors of LR in patients who had received treatment for both DCIS and IDC. CONCLUSIONS: p53 overexpression is a common predictor of LR following treatment for all stages of primary operable ductal carcinoma of the breast. This marker may help in planning optimal treatment and follow-up.     

Nek2和β-连接素在乳腺浸润性导管癌中的表达和意义

目的 探讨中心体相关调节因子Nek2和β-连接素(β-cat)在人乳腺浸润性导管癌(IDC)和IDC伴发的导管内癌(DCIS)中的表达及其意义.方法 采用免疫组织化学方法(IHC)检测186例IDC、伴发的75例DCIS和80例癌旁正常组织及40例乳腺纤维腺瘤中Nek2和β-cat蛋白的表达定位及表达水平,并与其他多个临床病理参数进行比较分析.结果 IDC中不同组织学分级(x2=8.756;P<0.05)、不同肿瘤大小(x2=6.518;P<0.05)间Nek2细胞质表达不同,在其他指标分组间表达差异无统计学意义(P>0.05);Nek2细胞核表达在IDC中有32例(32/186),在伴发的DCIS中有15例(15/75);IDC中不同组织学分级(x2=45.493;P<0.01)、TNM分期(x2=9.510;P<0.01)、淋巴结转移(Z=-2.035;P<0.05)、雌激素受体(ER)表达(Z=-3.004;P<0.01)组间[β-cat细胞膜表达有差异,在其他临床病理参数组间差异无统计学意义(P>0.05);β-cat细胞质表达在不同TNM分期间差异有统计学意义(x2=8.194;P<0.05),在其他参数组间差异无统计学意义(P>0.05);伴发的75例DCIS中Nek2和β-cat表达在各病理学参数组间差异均无统计学意义(P>0.05),Nek2细胞质表达与β-eat细胞质表达正相关(r=0.226,P<0.05).IDC中Nek2细胞质表达与β-cat细胞质表达正相关(r=0.368,P<0.01).此外,在75例伴发DCIS的病例中,β-cat细胞膜表达率在DCIS中比IDC中要高(Z=-3.804,P<0.01).癌旁正常组织和纤维腺瘤中Nek2细胞质和细胞核均为低表达或阴性,β-cat细胞膜均为高表达而细胞质均为低表达.结论 研究中心体调节因子Nek2和β-cat的表达可能成为探讨乳腺浸润性导管癌发生发展机制的途径.