肌上皮细胞标记物P63、α-SMA 和Calponin在乳腺良恶性疾病中的表达及意义

发布时间：2018-04-03 01:11

本文选题：乳腺肿瘤　切入点：肌上皮细胞　出处：《山西医科大学》2005年硕士论文

【摘要】：目的:探讨乳腺肌上皮细胞标志物 P63、α-SMA 和 Calponin 在乳腺良恶性疾病中的表达及意义。方法:筛选出癌旁含有乳腺正常组织和/或乳腺腺病及乳腺增生性病变(包括普通增生和不典型增生)的乳腺癌标本 67 例,根据《诊断外科病理学》的标准将这些病例石蜡切片中的病变分为 5 组:癌旁正常乳腺组、乳腺增生组、乳腺导管不典型增生组、原位癌组和浸润癌组。采用免疫组织化学的方法对上述病变同时标记 P63、α-SMA 和 Calponin 三种抗体。结果:在乳腺正常组、乳腺增生组、乳腺不典型增生组中,几乎所有的肌上皮细胞表达 P63、α-SMA 和 Calponin,而所有的腺上皮细胞三种抗体均为阴性;在原位癌组中三种抗体均表现为:部分癌巢外围可见完整的 P63、α-SMA或Calponin阳性的肌上皮细胞包绕,部分癌巢外围阳性的肌上皮细胞不完整,有些癌巢外围甚至无阳性肌上皮细胞;在浸润癌组所有的癌巢外缘均未见 P63 或 α-SMA 或 Calponin 阳性的肌上皮细胞。67 例乳腺癌病例中仅有 2 例浸润性癌见小灶状癌细胞 P63(+),无一例癌细胞 α-SMA(+)或Calponin(+)。在所有研究的乳腺良恶性病变中,基质中的肌纤维母细胞和血管平滑肌细胞均不表达 P63,而 α-SMA 和 Calponin 不同程度地有这种交叉反应。三种抗体在乳腺正常组、增生组、不典型增生组及原位癌组中的表达,经统计学分析: P63 和 Calponin 在四组间的阳性表达率均无统计学意义,α-SMA 在前三组间的阳性表达率无统计学意义,与第四组差别有统计学意义。结论:与 α-SMA、Calponin 相比,P63 显示乳腺肌上皮细胞具有相对较高的敏感性和特异性,可作为肌上皮细胞的又一有效的标志物。但是 P63有如下缺陷:①标记少许癌细胞;②有时部分明显的肌上皮细胞 P63 阴性;③ 正常组织中 P63(+)肌上皮细胞呈均匀或不均匀的点状线有时与一些病变中失去肌上皮细胞的断裂线难以辨认。这些可能会给诊断带来一些麻烦。
[Abstract]:Objective: to investigate the expression and significance of P63, 伪 -SMA and Calponin in benign and malignant breast diseases.Methods: 67 cases of breast cancer with normal breast tissue and / or breast adenosis and hyperplasia (including normal hyperplasia and atypical hyperplasia) were selected.According to the criteria of "Diagnostic Surgical Pathology", the lesions in paraffin sections of these cases were divided into 5 groups: normal breast adjacent to carcinoma, hyperplasia of mammary gland, atypical hyperplasia of ductus mammary gland, carcinoma in situ and invasive carcinoma.Three antibodies, P63, 伪 -SMA and Calponin, were labeled with immunohistochemical method.Results: in the normal group, hyperplasia group and atypical hyperplasia group, almost all myoepithelial cells expressed P63, 伪 -SMA and Calponin, but all the glandular epithelial cells were negative.In situ cancer group, the three kinds of antibodies were as follows: complete P63, 伪 -SMA or Calponin positive myoepithelial cells were found in the periphery of some cancer nests, and some positive myoepithelial cells were incomplete in the periphery of some cancer nests, and even no positive myoepithelial cells were found in some cancer nests.There were no p63 or 伪 -SMA or Calponin positive myoepithelial cells on the outer edge of the nests in invasive cancer group. Of 67 cases of breast cancer, only 2 cases of invasive carcinoma showed small focal carcinoma cells P63 (P 63), none of which was 伪 -SMA () or Calponin (P < 0.05).In all the benign and malignant breast lesions studied, the myofibroblasts and vascular smooth muscle cells in the matrix did not express P63, but 伪 -SMA and Calponin had this cross reaction in varying degrees.The expression of three kinds of antibodies in normal, proliferative, atypical hyperplasia and carcinoma in situ group,The positive expression rate of p63 and Calponin in the four groups was not statistically significant, and the positive expression rate of 伪 -SMA in the first three groups was not statistically significant, which was significantly different from that in the fourth group.Conclusion: compared with 伪 -SMA-Calponin, p63 has higher sensitivity and specificity than 伪 -SMA-Calponin, and can be used as another effective marker of myoepithelial cells.However, p63 had the following defects: 1: 1 labeled a few cancer cells, and sometimes some of the myoepithelial cells were p63 negative;(3) the point lines of P63 () myoepithelial cells in normal tissues are even or uneven, sometimes difficult to identify with the broken lines of the myoepithelial cells lost in some lesions.These may cause some trouble for the diagnosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R365

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