细胞角蛋白在乳腺疾病中的诊断价值

目的：探讨细胞角蛋白在不同乳腺疾病中的表达及其对乳腺疾病诊断和鉴别诊断的意义。方法：107例乳腺疾病患者中包括普通性导管增生（UDH）33例、不典型性导管增生（ADH）20例、导管原位癌（DCIS）34例,不同病变与浸润性导管癌（IDC）20例,采用免疫组化检测CK5/6、CK34βE12、CK19、CK8/18、SMA、ER、c-erbB-2的表达。结果：CK5/6和CK34βE12在ADH、DCIS、IDC中的表达率显著低于UDH（P〈0.01）;CK19、CK8/18在各组间的表达无明显差异;SMA在良性的肌上皮中表达,部分高级别DCIS中灶状缺如,在IDC中缺如。ER、c-erbB-2在不同疾病中表达模式不同。结论：CK5/6和CK34βE12的表达率有助于UDH与ADH和DCIS的鉴别;细胞角蛋白结合SMA、ER、c-erbB-2的表达可辅助乳腺良恶性疾病的鉴别诊断。细胞角蛋白对于乳腺导管内增生性病变的病理诊断及鉴别诊断有实用意义。

The expression of cytokeratin and its diagnosis significance in intraductal proliferative lesions of breast

Objective：To explore the expression and its diagnosis significance of different cytokeratin in intraductal proliferative lesions and invasive ductal carcinoma of breast.Methods：33 cases of UDH,20 cases of ADH,34 cases of DCIS,20 cases of IDC,that were studied by immunohistochemical staining using antibodies to CK5/6,CK34βE12,CK19,CK8/18,SMA,ER,c-erbB-2.Results：The positive expression rate of CK5/6 and CK34βE12 in ADH,DCIS,IDC was significantly lower than that in UDH（P0.01）.There was no significant difference of positive expression rate of CK19,CK8/18 among different breast lesions.The SMA was positive in myoepithelial cells in benign lesions,but partly negative in some of the high-grade DCIS and absence in IDC.The expression patterns of ER,c-erbB-2 were different among breast dis eases.Conclusion：The expression rate of CK5/6 and CK34βE12 is helpful to the differential diagnosis in UDH and ADH,DCIS.The cytokeratins combined with SMA,ER,c-erbB-2 can assist in the differential diagnosis in benign and malignant breast disease.The cytokeratins are useful markers for pathological diagnosis and differential diagnosis of intraductal prolif erative lesions of breast.