乳腺浸润性微乳头状癌上皮性钙黏附素的表达及意义

目的 研究细胞黏附分子,在乳腺浸润性微乳头状癌肿瘤细胞的集团性浸润、转移中的表达和作用。方法 复习2002年1月～2003年5月所有手术切除乳腺癌组织切片,按WHO乳腺癌分类分组,浸润性微乳头状癌(IMPC)64例、浸润性导管癌(IDC)57例。采用免疫组织化学标记的链霉素抗生物素蛋白-生物素(LSAB)法检测64例IMPC中E-钙黏附素的表达,并同IDC加以比较。结果 E-钙黏附素主要表达于IMPC细胞膜;IMPCE-钙黏附素表达率(85．9％,55／64)明显高于IDC(43．9％,25／57),并且在微乳头状肿瘤细胞集团内的细胞间连接面表达正常,而在细胞集团面向间质侧的表达明显减弱或不表达;IMPC组的淋巴结转移率(85．9％,55／64)明显高于IDC(52．6％,30／57)．．其淋巴结阳性、E-钙黏附素阳性病例的d-连接素、B-连接素共同表达率(45．1％,26／51)也明显高于IDC(15．4％,2／13)。结论 IMPC的微乳头状肿瘤细胞集团内细胞间黏附性强、而与间质间的黏附性减弱或消失的特性可能是IMPC具有高转移潜能的原因之一。

Relationship between expression of cell adhesion molecules and metastatic potential in invasive micropapillary carcinoma of breast

OBJECTIVE: To investigate the expression of cell adhesion molecules and Their significance in invasive micropapillary carcinoma (IMPC) of the breast. METHODS: Immunohistochemical study for E-cadherin was performed on 64 cases of IMPC and 57 cases of invasive ductal carcinoma (IDC). RESULTS: E-cadherin was mainly expressed on the cell membrane of tumor cells. The expression of E-cadherin in IMPC (85.9%, 55/64) was significantly higher than that in IDC (43.9%, 25/57). E-cadherin expressed in the intercellular contact surface of IMPC cells. In contrast, it was weakly positive/not expressed on the outer membranous surface of the tumor clusters in IMPC. The rate of lymph node metastasis in IMPC (85.9%, 55/64) was significantly higher than that in IDC (52.6%, 30/57), the rate of alpha-catenin and beta-catenin coexpression in IMPC (45.1%, 26/51) with lymph node metastasis and E-cadherin normal expression was also significantly higher than that in IDC (15.4%, 2/13). CONCLUSION: Weak cell adhesion molecule expression on the outer surface of IMPC cell clusters, in contrast to strong cohesion in intercellular contact surface, may help to explain the high metastatic potential of this type of breast cancer.