论文部分内容阅读
目的探讨MIB-1、p63在不同病理类型乳腺肿瘤中的表达及其临床意义。方法根据WHO(2003)乳腺肿瘤分类标准,收集乳腺肿瘤患者手术切除标本:非典型性增生(ADH)组24例、乳腺原位癌组(DCIS)20例、浸润性癌(IDC)组45例,乳腺普通型增生(UDH)20例作为对照组。应用免疫组化进行MIB-1、p63检测,观察其在不同病理类型乳腺组织中的分布及表达水平。结果p63在UDH、ADH、DCIS组中均有不同程度的阳性表达,主要表达于导管周围的肌上皮,ADH、DCIS两组间无明显差异,但与UDH组相比,其阳性表达率明显下降,在IDC组中p63几乎不表达;MIB-1主要表达于增殖细胞中的核抗原,阳性染色定位于肿瘤细胞核,MIB-1标记的增殖指数PI在UDH、ADH、DCIS、IDC组分别为2.25±0.54、4.08±0.57、5.50±0.56、30.22±2.41,从UDH到ADH、DCIS,再到IDC,PI显著升高,p63表达呈逐渐减弱。MIB-1在IDC表达与临床病理分期、分子分型有关,而与患者年龄、肿瘤大小、组织学分级、腋窝淋巴结转移及其个数无关,临床分期越晚(Ⅲ、Ⅳ期)、分子分型为HER-2型、三阴性患者,其PI均分别高于临床分期早(Ⅰ、Ⅱ期)、分子分型为管腔型A或B患者(P<0.05)。结论联合检测p63、MIB-1可以较好地反映乳腺增生性病变的程度,正确鉴别乳腺的良恶性病变,通过检测MIB-1的增殖表达水平可预测乳腺恶性肿瘤的浸润程度及整体预后评估。
Objective To investigate the expression and clinical significance of MIB-1 and p63 in different pathological types of breast tumors. Methods According to WHO (2003) classification of breast cancer, 24 cases of atypical hyperplasia (ADH), 20 cases of breast carcinoma in situ (DCIS) and 45 cases of invasive carcinoma (IDC) were collected. , 20 cases of common breast hyperplasia (UDH) as control group. Immunohistochemistry was used to detect MIB-1 and p63, and the distribution and expression of MIB-1 and p63 in different pathological types of breast tissues were observed. P63 expression were the result of varying degrees in the UDH, ADH, DCIS group, mainly expressed in no significant difference between the two groups myoepithelial surrounding the catheter, ADH, DCIS, but compared with the UDH group, which was significantly decreased expression , While p63 was almost not expressed in IDC group. MIB-1 was mainly expressed in proliferating cell nuclear antigen and positive staining was located in tumor nucleus. MIB-1 labeled proliferation index PI was 2.25 in UDH, ADH, DCIS and IDC groups respectively ± 0.54,4.08 ± 0.57,5.50 ± 0.56,30.22 ± 2.41. From UDH to ADH, DCIS, to IDC, PI increased significantly and p63 expression gradually decreased. The expression of MIB-1 in IDC was correlated with the clinical stage and molecular type, but not with the age, tumor size, histological grade, axillary lymph node metastasis and number of MIB-1. The clinical stage was later (stage Ⅲ and Ⅳ) Type of HER-2, triple negative patients, the PI were higher than the clinical stage of early (Ⅰ, Ⅱ), the molecular classification of luminal A or B patients (P <0.05). Conclusion Combined detection of p63, MIB-1 can reflect the extent of proliferative breast disease, benign and malignant breast lesions correct identification by detection of the expression level of proliferation of MIB-1 and infiltration predictable overall prognosis of breast cancer.