乳腺病变伴发生物矿化的类型及机制研究

A Study on the Main Types and Formation Mechanisms of Biomineralization Associated with Breast Lesions

乳腺病变伴发生物矿化的类型多样、机制复杂。本试验对手术切除或粗针穿刺获得的乳腺脂肪坏死标本5例、乳腺增生症8例、乳腺纤维腺瘤7例及乳腺浸润性癌或原位癌6例分别进行常规HE(苏木素-伊红)染色、普鲁士蓝、茜素红S、Masson三色特殊染色及Ⅲ型胶原、Ⅳ型胶原免疫组织化学染色,以观察各种病变伴发矿化的常规病理学改变及无机、有机成分的差异。染色结果显示各种矿化物的主要无机成分均为钙盐。脂肪坏死和纤维腺瘤伴发的矿化均与Ⅲ型胶原有关,乳腺增生症伴发的矿化与Ⅳ型胶原有关,而乳腺导管原位癌矿化与上述两种胶原的关系不大。根据形态可将乳腺病变伴发的生物矿化分为坏死相关性矿化及非坏死相关性矿化。前者又可分为肿瘤性坏死相关性矿化和非肿瘤性坏死相关性矿化。非坏死相关性矿化可分为上皮相关性矿化及间质相关性矿化。乳腺病变类型不同,其伴发矿化的机制也不尽相同。

The main types and formation mechanisms of biomineralization associated with breast lesions are various and complicated.Surgical resection specimens or core needle biopsy specimens of 5 breast fat necroses,8 benign proliferative breast diseases,7 breast fibrous adenomas and 6 breast infiltrative carcinomas/carcinomas in situ were selected in our study.Each case was dyed with routine HE（Hematoxylin-Eosin） stain,special stain with Prussian blue,Alizarin red S and Trichrome Masson staining,and immunohistochemistry stain with collagen Ⅲ,collagen Ⅳ.Staining results of their pathological changes with biomineralization,and differences of their organic and inorganic components were observed under the light microscope.The staining results indicated that the main inorganic components of all biomineralization types were all calcium salts.Biomineralization associated with fat necrosis and fibrous adenoma was related with collagen Ⅲ.Biomineralization associated with benign proliferative breast diseases was related with collagen Ⅳ.And collagen Ⅲ or Ⅳ cannot be found in mineralization products of breast ductal carcinomas in situ.According to their microscopic morphology,biomineralization in breast lesions could be divided into necrosis related mineralization and non-necrosis related mineralization.The former could be subdivided into tumor necrosis related mineralization and non-tumor necrosis related mineralization.The latter could be subdivided into epithelial related mineralization and stromal related mineralization.The lesion types of breast determine the particularity of biominerlization forms.