乳腺癌伴神经内分泌分化的特点及患者预后的临床研究

目的 通过观察雌激素受体(ER)、孕激素受体(PR)、原癌基因Her-2、细胞核增殖抗原Ki67在乳腺癌伴神经内分泌分化(NED)中的表达及癌组织分级和淋巴结转移情况,探讨乳腺癌伴NED的临床特点及预后.方法 2005年10月至2010年10月本院乳腺癌根治术或改良根治术确诊病例90例,通过观测CgA和Syn免疫组织化学染色结果,分为乳腺癌伴NED阳性和NED阴性两组.分析两组患者ER、PR、Her-2、Ki67的表达,组织学分级,淋巴结转移情况等指标的差异.结果 90例患者中NED阳性组33例,占36.67%.NED阳性组ER阳性和PR阳性表达分别为24例(占72.7%)、21例(占63.6%),明显高于阴性组(P＜0.05).NED阳性组Her-2、Ki67阳性表达分别为37例(占64.91%)、15例(占45.5%),与NED阴性组比较,差异有统计学意义(P＜0.05).NED阳性组组织分级为Ⅰ级的患者比例为(21.21%),明显高于NED阴性组(7.02%,P＜0.01).NED阳性组淋巴结转移≥1枚的为7例(21.2%),明显低于阴性组24例(42.1%),差异有统计学意义(P＜0.05).结论 乳腺癌伴NED具有恶化程度低,组织分级高,淋巴结转移少的特点,与不伴NED的乳腺癌相比,其预后较好.

Clinical investigation of the character and the prognosis of breast carcinoma with neuroendocrine differentiation

Objective To explore the expression of the estrogen receptor（ ER）, progesterone receptor（ PR）, proto - oneogene Her - 2 and proliferating cell nuclear antigen Ki67 in breast carcinoma with and without neuroendocrine differentiation （NED）. To estimate the clinical characteristic and prognosis of breast carcinoma with NED. Method 33 breast carcinoma with NED were named as observing group, 57 breast carcinoma without NED were named as control group. All the patients came from The lth People Hospital of Taizhou, and have diagnosed breast carcinoma according to WHO. We detected the following parameters： the expression of the ER, PR, Her - 2 and Ki67, and histological types, and lymph node metastasis. Finally, the difference of these parameters of the both groups was compared. Result In the observing group, 24 cases （72.7%） were ER positive and 21 cases （63.6%） PR were positive, 22 cases （66. 67% ） were Her -2 negative and 75 cases （54. 5% ） were Ki67 negative, there was significant difference against of the control group （P 〈 0.05 ）. In the observing group, the tumors were more grade （21.21% vs 7.02% ） , and less lymph node metastases （21.20% vs 42. 10% ）. Conclusion It is suggested that the prognosis of the breast carcinoma with NED is better than that without NED.