hTERT mRNA、UbcH10和Ki-67在乳腺大汗腺病变中的鉴别诊断价值

Value of differential diagnosis of hTERT mRNA,UbcH10 and Ki-67 in breast apocrine lesions

目的探讨UbcH10、Ki-67和hTERT mRNA在乳腺大汗腺病变中的鉴别诊断价值。方法免疫组织化学EnVision法检测标记物UbcH10和Ki-67,显色原位杂交检测hTERT mRNA在20例大汗腺化生(APM)、26例大汗腺腺病(AA)、32例非典型性大汗腺增生(AAH)、22例大汗腺导管内癌(ADCIS)和35浸润性大汗腺癌(IAC)的表达。结果 UbcH10、Ki-67和hTERT mRNA在APM、AA、AAH、ADCIS和IAC表达的阳性率分别为(10.0%、5.0%和45.0%)、(50.0%、50.0%和84.6%)、(62.5%、62.5%和81.3%)、(81.8%、81.8%和81.8%)和(94.3%、94.3%和85.7%),呈正相关。Ki-67在APM、AA、AAH、ADCIS和IAC中表达的平均增殖指数分别为1.01%、5.35%、7.53%、16.05%和31.12%。hTERT mRNA、Ki-67和UbcH10表达的阳性率在APM与AA、AAH、ADCIS和IAC相比较差异具有统计学意义(P<0.05),在AA、AAH、ADCIS和IAC相邻两组比较中差异均无统计学意义(P>0.05);Ki-67平均增殖指数在AA、AAH与ADCIS相比较差异具有统计学意义(P<0.05)。结论苏木精-伊红染色观察组织病理学特征,辅以免疫组织化学方法检测Ki-67,能够在一定程度上提高乳腺大汗腺谱系中良、恶性病变鉴别诊断的准确性。

Objective To investigate the value of UbcH10, Ki-67 and hTERT mRNA in differential diagnosis of breast apocrine lesions. Methods The expression of UbcH10 and Ki-67 was detected by immunohistochemical EnVision method, and the expression of hTERT mRNA was determined by chromogenic in situ hybridization in 20 cases of apocrine metaplasia （APM）, 26 cases of apocrine adenosis （AA）, 32 cases of atypical apocrine hyperplasia （AAH）, 22 cases of apocrine ductal carcinoma in situ （ADCIS） and 35 cases of invasive apocrine carcinoma （IAC）. Results The positive expression of UbcH10 in APM, AA, AAH, ADCIS and IAC was 10.0%, 50.0%, 62.5%, 81.8% and 94.3% respectively, that of Ki-67 was 5.0%, 50.0%, 62.5%, 81.8% and 94.3% respectively, and that of hTERTmRNA was 45.0%, 84.6%, 81.3%, 81.8% and 85.7% respectively. The average proliferation index of Ki-67 expression in APM, AA, AAH, ADCIS and IAC was 1.01%, 5.35%, 7.53%, 16.05% and 31. 12% respectively. There were significant differences in the positive expression rates of hTERT mRNA, Ki-67 and UbcH10 between APM and AA, AAH, ADCIS and IAC （P 〈 0.05）, while there was no significant difference between two adjacent groups of AA, AAH, ADCIS and IAC （P 〉0.05）. There were significant differences in the average proliferation index of Ki-67 among AA, AAH and ADCIS （P 〈0. 05）. Conclusion Observing the histopathological characteristics with HE staining and detecting Ki-67 with immunohistochemical method may improve the accuracy of differential diagnosis of benign and malignant lesions in the breast apocrine lineage to some extent.