乳腺癌C-erbB-2表达与临床病理特征相关性分析

Correlation of C - erbB - 2 Status and Histologic Features in 1 6 3 Invasive Breast Carcinomas of baoji area

目的研究乳腺癌C—erbB-2、ER、PR的表达情况，C—erbB-2及激素受体与乳腺癌分级的相关性以及C-erbB-2的表达与激素受体相关性的确切程度。方法应用免疫组化法、荧光Fish法检测163例浸润性乳腺癌组织中C．erbB-2、ER、PR的表达，统计分析C—erbB-2与ER、PR的表达及组织学分级的相关性。结果163例浸润性乳腺癌组织中C-erbB-2、ER、PR表达率分别为21．5％、64．4％、44．2％，5例黏液癌、3例小管癌、1例微乳头状癌均100．0％，ER不表达；C—erbB-2在Ⅰ级乳腺癌中不表达，Ⅱ级为22．3％，Ⅲ级为27，0％。ER的表达与组织学分级呈负相关。ER、PR阳性表达率在C．erbB-2阳性的病例中明显下降。C-erbB-2阳性的病例中有少部分ER、PR阳性表达。结论浸润性乳腺癌中只有少部分表达C—erbB-2。组织学级别可以提示ER的表达，级别高者ER的表达率低，而Ⅰ级癌大多会表达ER。C-erbB-2的过表达及扩增主要在Ⅱ．Ⅲ级癌中。C—erbB一2与ER、PR的表达呈明显的负相关性。

Objective To study the relationship between C-erbB-2 and estrogen （ER） and progesterone （PR） receptors,and the relationship between C-erbB-2,ER,PR with histologic grade. Methods To detect ER,PR and C-erbB-2 states by using immunohistochemical analysis and fluorescence in situ hybridization for C-erbB-2 in 163 unselected invasive breast carcinomas. Results C-erbB-2, ER, PR were expressed in 21.5% ,64.4% ,44.2% of 163 cases respectivly . 5 pure mucinous carcinomas , 3 tubular carcinomas and 1 micropapillary carcinoma were ER ＋ （ 100. 0% ） ,C-erbB-2 - （ 100.0% ） and PR ＋ （40.0% ,66. 7%, 100.0% ）. C-erbB-2 was positive in 22.3% of gradeⅡand 27.0% of grade Ⅲ invasive ductal carcinomas and negative in all grade Ⅰ invasive ductal carcinomas. ER and PR expression were decreased significantly in C-erbB-2 ＋ tumors compared with C-erbB-2 - tumors （ER, 25.7%vs 75.0% ;PR,25.7% vs 49.2% ）. Although ER or PR expression is decreased in C-erbB-2 ＋ tumors,a substantial proportion of them still express ER or PR. Conclusion C-erbB-2 overexpression or amplification was limited to a minority of invasive breast carcinomas. Tumour grade was an independent predictor for ER expression. ER was expressed in small number of high-grade and in large number of gradeⅠinvasive ductal carcinomas. C-erbB-2 overexpression or amplification essentially was limited to grades Ⅱ and Ⅲductal carcinomas and correlated inversely with ER or PR expression.