乳腺癌及其癌前病变中细胞凋亡与细胞增殖的原位观察

In situ observation of apoptosis and proliferation in breast cancer and its precancerous lesions

目的 通过原位观察乳腺癌及其癌前病变中细胞凋亡与细胞增殖的表达,探讨其在乳腺组织恶性转化进程中的作用。方法 利用原位DNA 断裂点的3羟基末端标记(TUNEL) 技术、增殖细胞核抗原(PCNA) 免疫组织化学染色原位观察31 例乳腺癌、20 例乳腺不典型增生、20 例乳腺单纯性增生中的细胞凋亡与细胞增殖,以8 例正常乳腺组织为对照。结果 正常乳腺组织中凋亡细胞多位于乳腺导管及腺泡的近腔面,增殖细胞位于基底部;乳腺单纯性增生、乳腺不典型增生及乳腺癌丧失了上述分布特征。乳腺不典型增生中凋亡细胞和增殖细胞密度均显著高于乳腺癌和正常乳腺组织( P< 0 .01) ,乳腺癌中的凋亡细胞和增殖细胞密度也显著高于正常组织( P< 0 .01) 。在乳腺单纯性增生和不典型增生中,凋亡细胞和增殖细胞密度比例分别为1∶1-3 至1∶1-4 ,1∶1-1 至1∶1-2 ;而在乳腺癌中其密度比例约为1∶2-3 至1∶2-4 。结论 细胞凋亡与细胞增殖异常可能是乳腺组织恶性转变过程中的重要指标之一。

Objective To investigate the effects of apoptosis and proliferation on malignant transformation of breast precancerous lesions by in situ observation.Methods The density and distribution of apoptotic cells were examined in 31 cases with breast cancer, 20 with dysplasia and 20 with hyperplasia, using TUNEL (TdT mediated dUTP nick end labeling) technique and immunohistochemical method respectively. Eight normal breast tissues were used as the control.Results In normal breast tissue, apoptotic cells were located at the lacteals and gland follicles, facing the cavity. The proliferating cells were located at the basal layer of mucosa. These characteristics of distribution were lost in breast cancer and precancerous lesions. The density of apoptotic cells and proliferating cells of dysplasia was significantly higher than that in breast cancer and normal mucosa, The density of apoptotic cells and proliferating cells in breast cancer was significantly higher than that in normal mucosa. The ratio of apoptotic to proliferating cells in hyperplasia and dysplasia was 1∶1.3～1.4, 1∶1.1～1.2 respectively, and 1∶ 2.3～ 2.4 in breast cancer.Conclusion Abnormality in cell apoptosis and proliferation may play important role in the genesis of breast cancer.