乳腺球蛋白在术前乳腺癌和腋窝淋巴结细针穿刺吸取组织中的表达及临床意义

目的 探讨乳腺球蛋白（mammaglobin,MAM）在术前乳腺癌及腋窝淋巴结细针穿刺吸取组织中的表达及临床意义.方法 对91例原发性乳腺癌行术前细针穿刺,将吸取的组织制备涂片,采用免疫组织化学方法（EnVision法）检测MAM表达,观察MAM表达与临床病理指标的关系.同时另收集15例原发性肺癌腋窝淋巴结转移患者,分析乳腺癌腋窝淋巴结转移、乳腺癌增生性淋巴结炎和肺癌腋窝淋巴结转移三者间术前腋窝淋巴结MAM表达的区别.统计分析采用χ2检验.结果 在91例原发性乳腺癌患者中MAM的阳性表达率为74.72%（68/91）.MAM的阳性表达与雌激素受体（ER）、孕激素受体（PR）、组织学分级、细胞学分级有关（P〈0.05）,与患者的年龄、肿瘤大小、淋巴结是否转移及HER-2状态无关（P〉0.05）.腋窝淋巴结观察结果显示,MAM在乳腺癌腋窝淋巴结转移患者中呈阳性表达,在乳腺癌增生性腋窝淋巴结炎和肺癌腋窝淋巴结转移患者中均为阴性表达.结论 MAM可表达于原发性和转移性乳腺癌,细针穿刺细胞学检查结合MAM的测定对乳腺癌的诊断及鉴别具有一定辅助判断价值.MAM阳性表达与ER、PR状态、细胞学分级、组织学分级有关,有利于了解肿瘤的生物学指标及判断预后.

Expression of mammaglobin in preoperatively aspirated breast cancer and axillary lymph node tissues and clinical significance

Objective To investigate the expression of mammaglobin （ MAM ） in preoperative breast carcinoma and axillary lymph node tissues using fine-needle aspiration （FNA） biopsy and its clinical significance. Methods Ninety-one cases of primary breast carcinoma were enrolled into the study. All cases received preoperative fine-needle aspiration biopsy. Immunocytochemistry for testing MAM was performed in all the cases using EnVision method to observe the relation between MAM positive expression and cytologic grading and clinicopathological parameters. In the meantime, 15 primary lung cancer patients were collected, with an intention of comparing the MAM expression in metastatic axillary lymph node of breast cancer, hyperp[astic axillary lymphadenitis of breast cancer and metastatic axillary lymph node of primary lung cancer. Statistical analysis was performed using chi-square test. Results The positive rate of MAM in primary breast carcinoma patients was 74.72% （68/91）. The positive expression of MAM was associated with estrogen receptor（ER）, progesterone receptor （PR）, cytological grade and histologic grade （P〈0.05）, while the MAM expression level was independent of age, tumor size, the status of axillary lymph node metastasis and HER-2 （P〉0.05）. The observation of MAM expression in axillary lymph nodes showed MAM positively expressed in the metastatic axillary lymph node of breast cancer, but negatively expressed in the hyperplastic axillary lymphadenitis of breast cancer and the metastatic axillary lymph node of primary lung cancer. Conclusion MAM expresses in both primary and metastatic breast carcinomas. FNA combined with testing MAM may be helpful for diagnosis and identification of breast cancer. The correlation of MAM positive expression with the status of ER, PR, cytological grade and histologic grade may have a potential value for preoperatively assessing the biological characteristics and the prognosis of the patients.