乳腺癌术前性激素受体和C-erbB-2检测的临床意义

目的研究乳腺癌术前ER、PR以及C-erbB-2的表达及临床意义。方法术前对30例女性原发乳腺癌患者行细针穿刺涂片,利用免疫细胞化学技术检测ER、PR、C-erbB-2,对术后相应的石蜡切片用免疫组化检测ER、PR、C-erbB-2,分析两种检测方法之间的关系。同时研究ER、PR与C-erbB-2之间相关性。结果30例术前细针穿刺者ER阳性15例(50%),PR阳性11例(36.7%)。相对应的30例石蜡切片组的ER阳性者13例(43.3%),PR阳性者9例(30%)。两者无显著性差异(P>0.05)。C-erbB-2癌基因蛋白在细针穿刺涂片上的阳性表达为16例(53.3%),阴性者14例(46.6%),相对应的石蜡切片上为阳性者13例(43.3%),阴性者17例(56.7%)。两者无显著性差异(P>0.05)。C-erbB-2癌基因蛋白阳性者ER阳性3例、PR阳性3例;C-erbB-2癌基因阴性者ER阳性12例、PR阳性8例。ER、PR与C-erbB-2的相关性呈负相关(P<0.05)。结论①术前细针穿刺涂片检测乳腺癌ER、PR、C-erbB-2与术后石蜡切片测定的乳腺癌ER、PR、C-erbB-2的结果无显著性差异,术前细针穿刺涂片检测乳腺癌ER、PR、C-erbB-2可于术前掌握乳腺癌细胞的生物学特性;②术前细针穿刺涂片检测的乳腺癌ER、PR与癌基因C-erbB-2呈负相关,两者结合,可更准确地判断乳腺癌的预后及对内分泌治疗的反应。

Expression of sex-hormone receptors and C-erbB-2 protein in preoperative breast cancer and their significance

Objective To study the expressions of ER,PR,C-erbB-2 in breast carcinoma patients before operation and their clinical significance.Methods The 30 females with primary breast carcinoma were undergone FNA preoperatively for determination of ER, PR and C-erbB-2 with immunocytochemical assay, routine paraffin sections were detected for the same items with immunohistochemical assay postoperatively. The obtained results were compared to find out the relationship between ER, PR and C-erbB-2.Results The ER positivity rate was 50% in all the 30 cases in FNA smears(15/30), but 43.3% in routine sections(13/30); while 36.7% PR positivity rate was found in FNA smears(11/30), 30% positivity rate in routine sections(9/30) with no significant differences(P>0.05). The C-erbB-2 positivity rate was 53.3% in FNA smears(16/30), 43.4% in routine sections(14/30), no significant differences were found.ER positivity and PR positivity in 3 cases were respectively found in C-erbB-2 positive cases while ER positivity in 12 and PR positivity in 8 cases were respectively detected in C-erbB-2 negative cases, the former was significant less than the latter(P<0.05). Conclusions There is no significant difference between ER, PR and C-erbB-2 determination on the FNA smears before operation and routine sections after operation; Detemination of ER,PR and C-erbB-2 by FNA preoperatively may contribute to understand the biological features.There is a negative relationship between ER, PR and C-erbB-2 by FNA before operation and the combination results could contribute to assess the prognosis of breast cancer and the response to the endocrine therapy.