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目的 探讨乳腺导管原位癌组织学分级与分型以及ｃｅｒｂＢ２ 蛋白、ｐ５３ 蛋白、ＭＩＢ１ 、雌激素受体（ＥＲ） 表达的关系，以期为临床判断潜在恶性程度及预后提供参数。方法 参照Ｖａｎ Ｎｕｙｓ 分类方法，对３２ 例乳腺导管原位癌按核的分级、有无坏死进行组织学分级，并将标本行ｃｅｒｂＢ２ 蛋白、ｐ５３ 蛋白、ＭＩＢ１、ＥＲ的枸橼酸微波ＡＢＣ免疫组化法染色。结果 Ⅰ级（分化好）１２ 例（３７．５％ ） ，Ⅱ级（中度分化）９ 例（２８．１％ ） ，Ⅲ级１１ 例（３４．４％ ）。Ⅲ级患者中，９ 例为粉刺型，１ 例为微乳头状型，１ 例为实体型，Ⅲ级的ｃｅｒｂＢ２、ｐ５３ 和ＭＩＢ１ 蛋白表达的阳性率分别高于Ⅱ级和Ⅰ级，并与Ⅰ级比较差异有显著意义（ Ｐ＜０．０５） ，ＥＲ阳性率低于Ⅱ级和Ⅰ级。结论 乳腺导管原位癌Ｖａｎ Ｎｕｙｓ 组织学分级可能是一个较好的预后指标。
Objective To investigate the relationship between the histological grade and type and the expression of cerbB2 protein, p53 protein, MIB1 and estrogen receptor (ER) in ductal carcinoma in situ, so as to provide parameters for clinical judgment of potential malignancy and prognosis. . Methods According to the Van Nuys classification method, 32 cases of ductal carcinoma in situ were graded by the nucleus and histologically graded for necrosis. The specimens were examined for c-erbB2 protein, p53 protein, MIB1, and ER. Acid-microwave-ABC immunohistochemical staining. Results Grade I (differentiated) was 12 (37.5%), grade II (moderately differentiated) was 9 (28.1%), grade III was 11 (34.4%). In grade III patients, 9 cases were acne, 1 case was micropapillary, and 1 case was solid. The positive rate of c-erbB-2, p53, and MIB-1 protein expression in grade III was higher than that in grade II. Grade I was significantly different from grade I (P<0.05), and the ER positive rate was lower than grade II and grade I. Conclusion Van Nuys histological grade in ductal carcinoma in situ may be a good prognostic indicator.