乳腺癌前不同病变中多种生物标志的变化规律及意义

Changes and implication of multi-biological markers in different precancerous lesions of breast

目的探讨多种生物标志在乳腺癌前不同病变中的变化规律及意义。方法免疫组化法检测ER、PR、pS2、p53和c-erbB-2在正常乳腺组织、单纯性增生、不典型增生和早期癌中的表达。结果ER、PR表达与乳腺增生病情程度密切相关(r=0.446,P<0.0001;r=0.363,P<0.0001),阳性表达率在不典型增生组分别为64.4%和73.3%,显著高于正常组(分别为11.5%和15.4%)和单纯增生组(分别为22%和28%)。pS2、p53、c-erbB-2在癌前不同病变中的表达率较低。发现>2个指标的共表达在不典型增生组为68.9%,显著高于正常组(3.8%,P<0.01)和单纯增生组(14%,P<0.01)。结论ER、PR是促进乳腺增生发展和癌变的重要影响因子,临近癌变存在显著增高的多生物指标共表达。

OBJECTIVE：To detect the changes and implication of multi-biological markers in the different precancerous lesions of breast. METHODS： The expressions of ER,PR,pS2,p53, （7 erbB 2 in breast normal tissue, hyperplasia, atypical hyperplasia and early-stage breast cancer were examed by the immunohistochemical technique. RESULTS： The expressions of ER and PR were related to the breast proliferative degree （r = 0. 446, P 〈0. 0001; r = 0.363, P 〈0. 000 1）; the positive expression rates of ER and PR in atypical hy perplasia were 64.4% and 73.3% respectively, significantly higher than those in normal breast tissue （11.5% and 15.4% respectively） and in hyperplasia （22% and 28% respectively）. The expression rates of pS2, p53, c-erbB-2 were relative low in the different precancerous lesions. The co-expressions with 2 markers or more were found in 68.9% atypical hyperplasia, significantly higher than those in normal breast （3.8%,P〈0.01） and in hyperplasia（14%,P〈0.01）. CONCLUSION= ER and PR are important factors to promote breast hyperplasia advance and carcinogenesis, and the co expressions of multi-biological markers are significantly accumulated in precancerous lesions.