| 摘要: |
| 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。 |
| 关键词: 乳腺肿瘤 MIB-1 p63 细胞增殖 |
| DOI： |
| 分类号: |
| 基金项目:浙江省医药卫生科技一般研究计划项目 |
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| Significance and expressions of cell proliferation markers (MIB-1 and p63) in Breast carcinoma |
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ZHOU Juandi, XIE Shangnao, WANG Guoliang, XIE Dafei, TANG Minmin, SHI Yijun, ZHAO Fuguang
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Zhejiang Hospital
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| Abstract: |
| Objective To explore the significance and expressions of cell proliferation markers ((MIB-1 and p63) in the differential diagnosis of benign and malignant breast lesions. Methods experiment group，including atypical duct hyperplasia (ADH, n=24), duct in situ arcinoma (DCIS, n=20) and invasive duct carcinoma (IDC, n=45), were obtained from our department according to the WHO classification of the breast cancer (2003)[1]. Usual duct hyperplasia (UDH, n=20) as control group.The immunohistochemical method was performed to detect expressions of MIB-1 and p63. Results In UDH, ADH and DCIS,the expressions of p63 were mainly located in the myoepithelial cells surrounding the glands, There was no deference among ADH and DCIS, In contrast to, UDH,the positive rate for p63 was significantly decreased in ADH and DCIS. In IDC focal positive cells for p63 was seened/t in the any case. The staining reaction of MIB-1 was maily confined to the cellular nucleus the cervical neoplasm. The PI labeled by MIB-1 in UDH, ADH, DICS and IDC groups were 2.25±0.54、4.08±0.57、5.50±0.56 and 30.22±
2.41 respectively. The PI increased remarkably from UDH ADH TO DCIS and then to IDC accordingly (P＜0.05). In contrast to p63
,the expressions of p63 were reduced remarkably. In IDC, MIB-1-high tumors were significantly associated with advanced stage (Ⅲ-Ⅳ)(P＜0.05) and Triple negative. But there has no something with ages, tumors in size, grade and lymphnode postivity (P ＞ 0.05). Conclusion A panel of myoepithelial markers, including MIB-1 and p63 ,can be used to differentiate the benign and
malignant breast lesions. Else, The level of ki-67 expression was also presented as a progrnostic factor predicting the treatment and risk stratification of breast cancer patients in future. |
| Key words: Breast tumor Proliferating cell MIB-1 p63 |
