乳腺良性病变和浸润性癌的不同间质反应及临床意义

Stroma reaction and clinical significance in benign lesion and invasive carcinoma of breast

目的探讨乳腺良性与恶性病变组织间质中成纤维细胞CD34和平滑肌肌动蛋白(SMA)的表达情况及其临床意义。方法70例乳腺病变组织标本,其中纤维腺瘤20例,硬化性乳腺病10例,浸润性导管癌30例,浸润性小叶癌10例。应用免疫组化法检测间质成纤维细胞CD34和SMA的表达;以10例正常乳腺组织作为正常对照。结果正常乳腺组织间质中成纤维细胞CD34呈强阳性表达,而SMA表达阴性(100%)。乳腺病变组织中,纤维腺瘤组织间质中的成纤维细胞CD34和SMA均呈阳性表达;浸润性导管癌和小叶癌的浸润的病灶内未见CD34+细胞,可见SMA阳性表达的肌纤维母细胞(100%)。结论对于乳腺病变组织,运用免疫组化法检测其间质中成纤维细胞CD34和SMA的表达,有助于判断病变组织的性质及浸润情况。

Objective To study the expression and clinical significance of CD34 and smooth muscle actin （SMA） in stroma of breast tissues and lesions. Methods Seventy cases of breast tissues and lesions, including 20 fibroadenomas, 10 sclerosing adnoses, 30 invasive ductal carcinomas and 10 invasive lobular carcinomas were investigated, and 10 normal breast tissues were served as controls. Immunohistochemical staining was applied to compare the distribution of CD34^＋ fibrocytes and SMA-reactive myofibroblasts. Results The stroma of normal breast tissue contained CD34^＋ fibrocytes, whereas SMA-reactive myofibroblasts were absent （100% for both）. All benign breast lesions exhibited astromal CD34^＋ fibrobytes, and fibroadenomas showed SMA-reactive myofibroblasts as well. In invasive ductal and lobular carcinoma the stroma was devoid of CD34^＋ fibrocytes, but a varying number of stromal SMA-reactive myofibroblasts were detectable （ 100% ）. Conclusion In breast carcer, immunohistochemical staining used in detecting expressions of CD34 and SMA is helpful in distinguishing benign lesions from malignancies.