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目的 探讨乳腺癌淋巴结转移及预后相关指标。方法 对56例乳腺癌术后原位石蜡包埋切片,应用计算机癌细胞DNA图像分析系统,进行DNA定量分析及癌基因C-erbB2蛋白表达对照观察。结果 在56例乳腺癌中术后病理诊断,前哨淋巴结(腋下淋巴结及内上象限淋巴结)转移的为39例,较非淋巴结转移的17例C-erbB2阳性表达率明显升高;有淋巴结转移的原位肿瘤C-erbB2阳性表达率为84.6％(33/39);而17例乳腺癌非淋巴结转移原位肿瘤C-erbB2阳性表达率仅23.5％(4/17)。对比组之间的差异具有显著性(P<0.05)。在淋巴结转移的乳腺癌中DNA图像定量分析,DNA质量随淋巴结转移数的增多而升高;DI指数在1.32～1.43之间,癌细胞周期中S期为61％～64.42％,G_2/M期1％～4.8％,DNA图像直方图倍体为异倍体(或多倍体5C～7C),表明预后差。结论 侵袭性乳腺癌有淋巴结转移C-erbB2阳性过度表达具有重要意义,癌细胞DNA图像分析G_2/M期细胞增高,可能是更有价值的预后指标。
Objective To investigate lymph node metastasis and prognosis of breast cancer. Methods Fifty-six cases of breast cancer were paraffin-embedded in situ after operation. The DNA of the cancer cells was analyzed by DNA image analysis system and the expression of C-erbB2 protein was observed. Results The pathological diagnosis of sentinel lymph nodes (axillary lymph nodes and upper quadrant lymph nodes) in 56 cases of breast cancer was 39 cases, which was significantly higher than that of 17 cases without lymph node metastasis. There was lymph node metastasis The positive rate of C-erbB2 expression was 84.6% (33/39) in situ tumors, while the positive rate of C-erbB2 in non-lymph node metastasis of breast cancer was only 23.5% (4/17) in 17 cases. The differences between the control groups were significant (P <0.05). The quantitative analysis of DNA in breast cancer with lymph node metastasis showed that the quality of DNA increased with the increase of lymph node metastasis. The DI index ranged from 1.32 to 1.43. The S phase in cancer cell cycle was 61% -64.42% 1% ~ 4.8%, DNA image histogram ploidy aneuploid (or polyploid 5C ~ 7C), indicating that the prognosis is poor. Conclusion Invasive breast cancer with lymph node metastasis C-erbB2 positive overexpression of great significance, cancer cell DNA image analysis of G 2 / M phase cells may be more valuable prognostic indicators.