乳腺良、恶性疾病的激素受体表达的对比分析

Comparative analysis of hormone receptor expressions in benign and malignant disease of breast

目的:检测乳腺癌(CA)、乳腺纤维腺瘤(FA)、乳腺增生病(HDB)的雌、孕激素受体(ER、PR)的表达,探讨它们之间的差异性。方法:采用SP法免疫组化染色对乳腺肿物标本进行ER、PR检测,并收集临床资料进行对比分析。结果:ER、PR表达的阳性率,CA组为67.5%和68.5%,与FA组的95.1%和97.6及HDB组的90.5%和97.6%比较,有显著性差异(P<0.001);FA组与HDB组ER、PR表达的阳性率比较,无显著性差异(P>0.05);CA组平均年龄和肿物大小分别与FA组和HDB组比较,有极显著性差异(P<0.001)。结论:FA组和HDB组ER、PR表达的阳性率明显高于CA组,提示CA中有雌激素依赖性和非雌激素依赖性的差异,而FA和HDB对雌激素的敏感性更明显;随患者年龄增大,或随着肿物增大,罹患乳腺癌的风险增高。因此,应重视乳腺良性疾病的治疗,对中、老年妇女乳腺肿物及时手术切除以降低罹患乳腺癌的风险;强调术后进行适当的药物干预性治疗以减少疾病再发或转变的倾向,这种寓防于治的策略是中医"既病防变"思想的充分体现。

Objective： To detect the expressions of estrogen receptors and progesterone receptors （ER, PR） in breast cancer （CA）, fibroadenoma of breast （FA）, hyperplastic disease of breast （HDB）, and explore the differences among them. Methods： The expressions of ER and PR of breast tumor were assessed by SP immunohistochemistry, and the clinical data collected were analyzed and comparied. Results： The positive rate of ER, PR in CA group was 67.5% and 68.5%, compared with the positive rate that in FA group （95.1% and 97.6% ） and HDB group （90.5% and 97.6%）, the differences were significant （P〈 0.001）; compared the positive rate of ER, PR in FA group and HDB group, there was no significant difference （P〉0.05）; compared with the FA group and HDB group, the average age and tumor size in CA group were significant difference （P〈 0.001）. Conclusion： The positive rate of ER, PR in FA group and HDB group were significantly higher than that in CA group, suggested there have differences between CA in the estrogen-dependent and non-estrogen-dependent, sensibilities of estrogen in FA and HDB are more obvious; risks of breast cancer are increased with age and tumor size. Therefore, we should pay attention to the treatment of benign breast disease, especially to that of older women＇s removed the breast tumor in time will reduce the risk of breast cancer; the intervention of drug treatment after operation will reduce the recurrence of disease or the tendency of mass change, which put anti-governance strategy in Chinese medicine, ＂preventing the development of the occurred disease＂ idea into reality.