乳腺导管非典型增生上皮细胞的超微结构研究

目的：观察乳腺导管单纯性增生、非典型增生、乳腺癌细胞超微结构特点，研究乳腺导管非典型增生上皮细胞恶性转化过程中的形态结构特点及变化规律。方法：应用透射电子显微镜观察乳腺增生症20例（其中导管单纯性增生4例，轻度非典型增生5例，中度非典型增生5例，重度非典型增生6例）及乳腺癌10例细胞的超微结构。结果：乳腺导管非典型增生上皮超微结构变化介于单纯性增生及乳腺癌细胞之间，表现为微绒毛紊乱，数量减少。细胞间缝隙连接、镶嵌连接及桥粒数量减少及结构发育不良。细胞器数量增多，但发育不全。细胞核增大不规则，染色较深，增生细胞间可见肌上皮细胞。这些改变与乳腺导管单纯性增生、乳腺癌组织明显不同。但重度非典型增生细胞改变接近癌细胞。结论：乳腺导管非典型增生细胞是从良性向恶性过渡的中间细胞，重度非典型增生细胞超微结构接近乳腺癌细胞，说明这些细胞已具备潜在的恶性趋势。要从整体形态分析，鉴别二者的超微结构变化。

Ultrastructure of Epithelial Cells in Mammary Atypical Ductal Hyperplasia

Objective:Our aims were to investigate the ultrastructure of cells in benign hyperplasia,atypical hyperplasia,and carcinoma of breast,and to identify its difference in different stages of carcinoma.Methods:Transmission electron microscopy was used to observe the ultrastructure of cells of 20 mammary hyperplasia cases including 4 benign hyperplasia,5 mild atypical hyperplasia,5 medium atypical hyperplasia,6 severe atypical hyperplasia,and 10 breast carcinoma. Results:The changes of ultrastructure in atypical hyperplasia were compared with benign hyperplasia and breast cancinoma.It is characterized by reduction and disturbance of microvilli,reduction and defect of gap junction,tight junction and desmosome junction.The number of organels increased but the function is insufficient.Enlargement and irregularity of nucleus with deep stained chromatin can also be observed.There are also some myo epithelial cells among the hyperplasia epithelial cells.These changes are different from those of benign hyperplasia and carcinoma.But in severe atypical hyperplasia,the changes are similar with those in carcinoma.Conclusion:The atypical hyperplasia epithelial cells are in fact origined from normal epithelial cells and may undergo malignant transformation.Changes in severe atypical hyperplasia and carcinoma show that these cells possess latent malignant tendency.We must depend on intergral cell morphology to identify the difference between the two .