AgNOR检测在乳腺疾病中的应用

APPLICATION OF AgNOR STAIN FOR TISSUE SECTIONS FROM BREAST LESIONS

细胞核内核仁组成区相关嗜银蛋白（ＡｇＮＯＲ）的检测对乳腺良、恶性病变的鉴别诊断具有价值［１］。本文对４５１例乳腺恶性、良性及交界性病变进行了ＡｇＮＯＲ检测，发现良性组与恶性组无论数量还是形态、大小都有显著差异（Ｐ＜０．００１）。恶性肿瘤伴腋下淋巴结转移的病人术后２年内发生远处转移或死亡组其ＡｇＮＯＲ计数与无远处转移存活组比较有显著差异（Ｐ＜０．００５）．在交界性病变中ＡｇＮＯＲ平均计数介于良恶性之间，（平均计数４．５２）．在复发或癌变者的ＡｇＮＯＲ颗粒基本为弥散型或混合型，发生癌变者计数均超过平均值。我们认为交界性病变ＡｇＮＯＲ计数及形态对临床处理和估计预后均有价值。结果提示在非恶性病变的诊断中，尤其在交界性病变中ＡｇＮＯＲ计数大于４．５，且以弥散型或混合型为主者，要结合病人年龄及临床表现作出适宜的手术处理。

Paraffin sections of 451 surgical breast lesion samples (benign 198 cases,malignant 213 cases,border line 40 cases) were analysed with AgNOR stain.The average number of positive particles per cell was 7.47 in malignant cases,2.17 in benign cases (P<0.001),and 4.52 in border line cases.In malignant tumors and in recurrent cases,most particles were disperse or mixed type,and it was often nucleolar type in benign cases.The authors suggest that,in case of border line lesion,if AgNOR particle is more than 4.5 in number and in disperse or mixed type,an appropriate surgical treatment should be considered.