单克隆抗体p63在乳腺良恶性病变诊断中的意义

目的探讨单克隆抗体p63在乳腺疑难病变鉴别诊断中的价值。方法收集各种乳腺病变组织标本66例，采用免疫组化染色方法，同时标记p63和SMA作对比研究。结果16例乳腺良性病变和11例导管原位癌中存留的肌上皮细胞几乎全部p63和SMA( )，4例良性病变中的少数导管见p63呈不均匀的间断表达，p63与间质肌纤维母细胞和血管平滑肌细胞无交叉反应；50例恶性病变中仅2例见小灶状癌细胞p63( )。SMA除标记肌上皮细胞，还与间质肌纤维母细胞和血管平滑肌细胞等成分有交叉反应。结论p63可作为识别乳腺肌上皮细胞的一个新的特异性标志，同时检测p63和SMA有助于提高乳腺疾病的诊断准确率。

Expression and significance of p63 protein in breast lesions

Objective To investigate p63 protein expression and its significance in difficult breast lesions. Methods We compared the patterns of reactivity of antibodies with p63, SMA (smooth muscle actin) on 66 breast lesions by using immunohistochemical SP method. Results All two antibodies were positive in the vast majority of myoepithelial cells in all 16 cases of benign breast lesions and 11 cases of ductal carcinoma in situ. 4 cases of benign lesions showed focal gaps in the myoepithelial cell layer, reflecting in discontinuous positive immunostaining around ductal structures. No cases showed p63 expression by myofibroblasts or vascular smooth muscle cells.Tumor cells in 4% of cases showed focal p63 expression. All cases showed SMA expression by myofibroblasts or vascular smooth muscle cells. Conclusions p63 may represent a new myoepithelial marker that can complement SMA in the analysis of difficult breast lesions.