34βE12、CK5/6、p63、SMA在乳腺增生、不典型增生与原位癌鉴别诊断中的价值

The Application of 34βE12、CK5/6、p63、SMA in the Identification and Diagnosis ofHyperplasia of Mammary Glands,Atypical Hyperplasia and Carcinoma in Situ

目的探讨高分子量细胞角蛋白34βE12、细胞角蛋白CK5/6、肌上皮标记物p63、平滑肌肌动蛋白SMA在乳腺增生、不典型增生与原位癌鉴别诊断中的价值。方法采用免疫组织化学染色法(SP),检测34βE12、CK5/6、p63、SMA在30例乳腺普通型增生(UDH)、30例非典型导管增生(ADH)、20例导管原位癌(DCIS)和20例浸润性导管癌(IDC)中的表达。结果 UDH和ADH组中34βE12均呈阳性表达,DCIS和IDC组中大部分34βE12呈阴性表达,前两组与后两组比较,差异均有统计学意义(P<0.05);UDH组中CK5/6均呈阳性表达,ADH、DCIS及IDC组中CK5/6大部分呈阴性表达,UDH组与其他3组比较差异有显著性(P<0.05);p63表达量依次为UDH组>ADH组>DCIS组,IDC组中其无阳性表达,各组间差异均有统计学意义(P均<0.05);UDH、ADH和DCIS组中SMA均呈阳性表达,IDC组中其大部分呈阴性表达,与前3组比较,差异均有统计学意义(P均<0.05)。结论联合检测34βE12、CK5/6、p63、SMA表达,有助于鉴别乳腺增生、不典型增生与原位癌,为临床提供可靠的诊疗依据。

Objective To explore the expression of high molecular weight cytokeratin（34βE12）,cytokeratin（CK5/6）,myoepithelium marker（p63） and smooth muscle actin（SMA） and to assess their value as markers in the differential diagnoses of hyperplasia of mammary glands,atypical hyperplasia and carcinoma in situ.Methods Immunohistochemical staining was performed to detect the expression of 34βE12,CK5/6,p63 in 30 cases usual ductal hyperplasia（UDH）,30 cases atypia ductal hyperplasia（ADH）,20 cases ductal carcinoma in situ（DCIS） and 20 cases infiltrating duct carcinoma（IDC）.Results 34βE12 was positive in UDH and ADH group and negative in DCIS and IDC group,with significantly statistical difference between the two groups（P0.05）.CK5/6 was positive in the UDH group and mostly negative in ADH,DCIS and IDC group,there was significantly statistical difference between these groups（P0.05）.The expresssion of p63 descended gradually in UDH,ADH and DCIS,and was negative in IDC group.There was significantly statistical difference between them（P0.05）.SMA was positive in the UDH,ADH and DCIS group and mostly negative in IDC group,compared with the prior 3 groups,there was significantly statistical difference between them（P0.05）.Conclusion Joint detection of the expression of 34βE12、CK5/6、p63 and SMA contributes to identification of hyperplasia of mammary glands,atypical hyperplasia,and carcinoma in situ.It can provide reliable diagnosis and treatment.