基底膜在乳腺良、恶性病变中的分布及意义──免疫组织化学及超微结构研究

DISTRIBUTION AND SIGNIFICANCE OF BASEMENT MEMBRANE IN BENIGN AND MALIGNANT LESIONS OF THE BREAST: IMMUNOHISTOCHEMICAL AND UITRASTRUCTURAL STUDY

本文应用抗Ⅳ型胶原和层粘连蛋白（ＬＮ）免疫组化和电镜观察全部１８４例乳腺病变（其中乳腺癌９１例，良性病变９３例）的基底膜（ＢＭ）分布状态，包括乳腺病、硬化性腺病、上皮增生、纤维腺瘤、乳头状瘤、导管内癌和浸润癌。所有良性病变及导管内癌中，ＢＭ完整分布于上皮与间质交界处；而所有浸润性癌癌巢周没有或仅有变细、断裂的ＢＭ残留；浸润性导管癌组织学分级与ＢＭ分布变化无关；Ⅳ型胶原与ＬＮ显示ＢＭ的效果无明显差别。上述结果提示：ＢＭ分布规律有助于鉴别乳腺良性病变、原位癌与浸润癌。ＢＭ缺乏是癌组织发生浸润的一种因素。

Immunohistochemical detection against type IV collagen and laminin (LN) and ultrastructuraldetection of the basement membrane(BM)was performed in a total of 184 cases of breast lesions(98breast carcinomas and 91 benign lesions).Histologically,the lesions were diagnosed asadenosis,sclerrosing adenosis,epitheliosis,fibroadenoma,papillomatosis,ductal carcinoma in situand invasive carcinoma.In all benign lesions and ductal carcinoma in situ,a distinct andcontinuous BM,containig both laminin and type IV collagen was found at the epithelial stromalinterface.On the contrary, no BM deposition or only attenuated and fragmented BM could bedemonstrated in all cases of invasive cardnoma。NOrelationship between histological malignancygrade of the infiltrating ductal carcinoma and the extent of BM deposition was ob-served.Ultrastructural finding of the BM in various breast lesions were consistent with theimmunostaining results.Our study suggests that the demonstration of BM in which type IVcollagen and LN show the same result can be value in the differential diagnosis between benignbreast lesions, carcinoma in situ and invasive carcinoma BM defect is a factor for invasion to occur.