核仁组成区嗜银蛋白及Ki-67在乳腺癌前驱病变中的意义

Significance of AgNOR analysis and the expression of Ki-67 in the precursor lesions of the breast carcinoma

目的探讨核仁组成区嗜银蛋白（AgNOR）及细胞增殖指数（PIki-67）在乳腺癌前驱病变中的意义。方法将76例乳腺癌前驱病变，包括导管上皮不典型增生（ADH）25例、低度导管原位癌（DCIS）17例、中度导管原位癌14例及高度导管原位癌20例，制成组织芯片，进行AgNOR嗜银染色及Ki-67免疫组织化学染色，图像定量分析AgNOR染色结果并计算PI Ki-67结果AgNOR颗粒形态、大小在各病变中存在差异；每个细胞AgNOR颗粒平均个数、AsNOn颗粒总面积、单个Ag—NOR颗粒面积、PIKi埘从ADH到高度DCIS逐渐增高，ADH、低度DCIS与高度DCIS的差异均有统计学意义（P〈0．01），ADH与低度DCIS在每个细胞AgNOR颗粒平均个数上的差异有统计学意义（P〈0．05）。结论AgNOR与Ki-67是乳腺癌前驱病变诊断及鉴别诊断的指标之一。

Objective To study the diagnostic and differential diagnostic significance of argyro- philic nucleolar organizer region （AgNOR） and cellular proliferation index （ PIKi-67 ） in the precursor lesions of the breast carcinoma. Methods Image quantitative analysis of AgNOR and immunostains of Ki-67 in tissue microarray sections from 76 biopsies of the precursor lesions of the breast carcinoma. Results There were some differences in granulae sizes and shapes of AgNOR among the precursor lesions of the breast carcinoma. The number of AgNORs per nucleu, total area of AgNORs,mean area of a single AgNOR, PIki-67 were increasing from ADH to high-grade DCIS, and there was statistical difference between ADH, low-grade DCIS,respectively and high-grade DCIS. The number of AgNORs per nucleu was statistically different be- tween ADH and low-grade DCIS. Conclusion AgNOR and Ki-67 could be regarded as assistant indicators in the diagnosis and differential diagnosis of the precursor lesions of the breast carcinoma.