CD10,p63及calponin在乳腺良恶性病变鉴别诊断中的意义

The value of CD10,p63 and calponin in differential diagnosis between benign and malignant breast lesions

目的探讨乳腺肌上皮细胞标志物CD10,p63及calponin在乳腺良、恶性上皮性病变鉴别诊断中的意义。方法应用免疫组织化学染色法检测CD10,p63及calponin在乳腺普通型增生(UDH),非典型导管上皮增生(ADH),导管原位癌(DCIS)和浸润性导管癌(IDC)中的表达,分析其在乳腺良、恶性上皮病变诊断中的意义。结果 3种标志物在UDH,ADH和DCIS组中均有不同程度的表达,且主要表达于导管周围的肌上皮。该3组间calponin的表达量无明显差异(P>0.05);p63的表达量依次为UDH组>ADH组>DCIS组(均P<0.05);CD10的表达量在UDH组与ADH组间无明显差异,但两组均明显高于DCIS组(均P<0.05)。IDC组几乎无CD10和p63的表达,肿瘤间质有少量calponin的表达,与前3组比较,差异均有统计学意义(均P<0.0 5)。结论联合应用CD1 0,p6 3及calponin标志物的检测可鉴别诊断乳腺良恶性病变,CD1 0和p6 3特异性较好,而calponin的敏感性较好,但特异性较差。

Objective To investigate the value of CDI0, p63 and ealponin, the markers of breast myoepithelial ceils, in differential diagnosis between benign and malignant epithelial lesions of the breast. Methods The expressions of CD 10, p63 and ealponin in usual duetal hypeIplasia （ UDH ） , atypical ductal hyperplasia （ADH） , ductal carcinoma in situ （DCIS） and invasive duetal carcinoma （ IDC ） of the breast were detected by immunohistoehemical staining, and their diagnostic roles in benign and malignant epithelial lesions of the breast were analyzed. Results All the three markers of breast myoepithelial cells were expressed in the tissues of UDH, ADH and DCIS groups to varying degrees, and were mainly expressed in the myoepithelial cells around the mammary duct. The expression level of calponin had no difference between the three groups, and the expression level of p63 was in the order of UDH group 〉 ADH group 〉 DCIS group （all P 〈 0.05 ）. The expression levels of CD10 between UDH group and ADH group were similar, but both were higher than that of the DCIS group （ both P 〈 0. 05 ） . There was almost no expression of CD10 and p63, and little expression of calponin in tumor stroma of the IDC group, and all of these had statistical differences compared with the above three groups （all P 〈 0. 05 ）. Conclusions Combination detection of CD10, p63 and calponin can be used for the differential diagnosis between benign and malignant breast lesions. Of these markers, CD10 and p63 have better specificity, while calponin has high sensitivity but less specificity.