CD44v6在乳腺导管内乳头状瘤及其癌变鉴别诊断中的意义

目的 比较CD44v6及HHF35在乳腺导管内乳头状瘤及其癌变组织的表达,探讨CD44v6在两者鉴别诊断中的价值。方法对49例导管内乳头状瘤、12例导管内乳头状瘤癌变组织的石蜡切片进行免疫组织化学染色。结果在导管内乳头状瘤、乳头状瘤癌变组织中,肌上皮细胞的CD44v6表达阳性率分别为85.7％,33.3％,相互之间差异无显著性(P>0.05);而上皮性肿瘤细胞的CD44v6表达阳性率分别为26.5％,83.3％,相互之间差异有显著性(P<0.01)。HHF35在导管内乳头状瘤、乳头状瘤癌变组织中阳性表达率分别为93.9％,41.7％,两者之间差异有显著性(P<0.01)。在肌上皮细胞CD44v6及HHF35呈双阳性的导管内乳头状瘤中,34/42例CD44v6在上皮性肿瘤细胞呈阴性;在肌上皮细胞CD44v6及HHF35呈双阴性的乳头状瘤癌变中,4/4例CD44v6在上皮性肿瘤细胞呈阳性。结论通过免疫组化检测CD44v6蛋白表达对导管内乳头状瘤癌变的鉴别诊断有一定的参考价值,结合HHF35的检测,可提高导管内乳头状瘤癌变鉴别诊断的有效性及实用性。

The value of CD44v6 in differentiating intraductal papilloma of the breast from its malignant transformation

Objective To evaluate the diagnostic value of CD44v6 in distinguishing between benign and malignant papillary lesions of the breast by comparing expressive level of CD44v6 and HHF35. Methods The level of CD44v6 and HHF35 were detected by immunohistochemistry in 61 paraffin - embeded samples. Results The positive expression rate of CD44v6 in the basal epithelial cells of intraductal papilloma and its malignant transformation was 85.7% and 33.3% respectively. The difference between the two lesions was not statistically significant(P> 0.05) . The positive expression rate in the luminal epithelial cells was 26. 5% and 83.3% respectively with significant difference(P<0.01) . The positive expressive rate of HHF35 in the intraductal papilloma and its malignant transformation was 93.9% and 41.7% , with statistically significant (P< 0.01) . In 42 cases of intraductal papilloma, which positively reacted with CD44v6 and HHF35 in the basal epithelial cells, there were 33 cases reacting negatively with CD44v6 in epithelial tumour cells. Four cases of malignant papillary lesions, which negatively reacted with CD44v6 and HHF35 in the basal epithelial cells, were all reacting positively with CD44v6 in epithelial tumour cells. Conclusion CD44v6 detection by immunohistochemistry is useful in distinguishing intraductal papilloma of breast from its malignant transformation. By combining with HHF35, the diagnositic practicability and validity will increase.