E-钙黏附蛋白和p120-连环素蛋白在乳腺浸润性小叶癌和导管癌中的表达差异及意义

目的 比较乳腺浸润性小叶癌(ILC)和浸润性导管癌(IDC)的临床病理学特征,探讨E-钙黏附蛋白(E-cadherin)和p120-连环素蛋白(p120-catenin)在ILC和IDC中的表达差异及意义.方法 中国医学科学院肿瘤医院1999年1月至2006年12月共收治ILC 123例,2000年收治IDC 334例.运用组织微阵列及免疫组织化学染色技术,对123例ILC和334例IDC患者的组织蜡块进行切片,并进行E-cadherin和p120-catenin表达的检测,同时对患者进行随访.结果 ILC和IDC患者的5年无瘤生存率(DFS)分别为61.8%和83.7%(P＜0.001),5年总生存率(OS)分别为81.7%和79.1%(P=0.055).在36例ILC和221例IDC患者中,E-cadherin表达缺失率分别为55.6%(20/36)和20.4%(45/221,P＜0.001),p120-catenin胞浆表达率分别为66.7%(24/36)和16.3%(36/221,P＜0.001).在ILC患者中,p120-catenin胞浆表达与E-cadherin表达缺失相关(P=0.002).ILC和IDC患者中,p120-catenin胞浆表达合并E-cadherin表达缺失的比率分别为55.6%(20/36)和4.1%(9/221,P＜0.001).结论 ILC具有不同于IDC的临床病理学特点及预后特征,E-cadherin和p120-catenin的检测有助于ILC和IDC的鉴别诊断.

Expression pattern of E-cadherin and p120-catenin in infiltrating lobular carcinoma and ductal carcinoma of the breast and its significance

Objective To determine how patients with infiltrating lobular carcinoma(ILC)differ from patients with the more common infiltrating ductal carcinoma(IDC),and observe the different expression patterns of E-cadherin and p120-catenin proteins in both ILCs and IDCs.Methods The patients with ILC admitted to our hospital from Jan 1999 to Dec 2006 and patients with IDC from Jan 2000 to Dec 2000 were included in this study.All their pathological slides were reviewed,and their clinical data and treatment variables were analyzed retrospectively.Then the expression patterns of E-cadherin and p120-catenin proteins in both ILCs and IDCs were detected by immunohistochemistry on tissue microarray.Results The 5-year overall survival was 81.7% for ILCs and 79.1% for IDCs(P=0.055).The 5-year disease-free survival was 61.8% for ILCs and 83.7% for IDCs(P＜0.001).Cytoplasmic localization of p120-catenin and loss of E-cadherin expression were more common in ILCs than in IDCs.The complete losses of Ecadherin in ILCs and IDCs were 55.6%(20/36)and 20.4%(45/221,P＜0.001),respectively.The p120-catenin showed a diffuse cytoplasmic localization in 66.7%(24/36)of ILCs and 16.3%(36/221)of IDCs(P＜0.001).Interestingly,the cytoplasmic localization of p120-catenin was clearly associated with the absence of E-cadherin expression in ILCs(P=0.002),cytoplasmic localization of p120-catenin and absence of E-cadherin expression were observed 55.6%(20/36)in ILCs compared with 4.1%(9/221)in IDCs(P＜0.001).Conclusion ILC has several specific biological and prognostic characteristics which are different in IDC.Different expression patterns of E-cadherin and p120-catenin proteins can be helpful to recognize ILC from IDC.