乳腺导管上皮非典型增生恶变潜能的量化评估

The Ouantitative Evaluation of Malignant Potential Of Breast Atypical Intraductal Hyperplasia

目的 探讨乳腺导管上皮非典型增生 (AIDH)恶变潜能的量化评估方法。方法 :应用自动图像分析系统对正常乳腺组织 10例 (正常组 ,NB)、乳腺导管上皮单纯性增生 33例 (增生组 ,IDH )、非典型增生 2 7例 (非典组 ,AIDH)和浸润性导管癌 37例 (导管癌组 ,IDCa)进行细胞DNA含量 (DI)及倍体分析、细胞核形态学计量。结果 1.在NB、IDH、AIDH和IDCa各组 ,DI及倍体分析参数 3- 4c %、5c %、>5c %均依次显著增高 (P均 <0 .0 1) ,2c %依次显著降低 (P <0 .0 1) ;核形态学参数 [核面积 (ar)、核周长 (ci)、核长径 (dl)、核短径 (ds)、核形状因子 (df) ]均依次显著增加 (P均<0 .0 1)。除 3- 4c %外 ,两类参数在非典组与导管癌组间有显著差异 (P <0 .0 5或P <0 .0 1)。 2 .ar、ci、dl、ds和df分别与DI、3- 4c %、5c %、>5c %呈显著正相关 ,与 2c %呈显著负相关。 3.根据图像分析ar、df、DI、2c %、5c %和 >5c % 6项指标的计量结果 ,建立乳腺导管上皮非典型增生和导管癌的判别方程 :Ya =- 2 76 .148+ 0 .12 3ar + 4 96 .832df + 10 9.330DI + 1.50 1(2c % ) - 0 .4 59(5c % )- 2 .2 87(>5c % ) ;Yc =- 2 82 .12 6 + 0 .154ar + 4 99.6 4 1df + 111.753DI + 1.4 2 3(2c % ) - 0 .2 2 1(5c % ) - 2 .36 7(>5c % )结论 ?

Objective To investigate the quantitative evaluation method of the malignant potential of breast atypical intradutal hyperplasia. Method:the parameters of nuclear DNA content (DI)and DNA ploid analysis (2c%,3-4c%,5c%,>5c%)and nuclear morphometry(ar,ci,dl,ds,df)were measured by CMIAS-007 image analysis system in 10 cases of normal nreast ductal epithelial tissue (NB),33cases of intraductal epithelial hyperplasa(IDH),27cases of atypical intraductal epithelial hyperplasia (AIDH)and 37 cases of infiltrating ductal carcinoma (IDCa).Results 1.DI and 3-4c%,5c%,>5c%and ar,ci,dl,ds,df increased gradually significantly in NB,IDH,AIDH and IDCa,while 2c% decreased significantly,and there was significant difference between AIDH and IDCa,2.ar,ci,dl,ds and df correlated significantly positively with DI、3-4c%、5c%、>5c%,significantly negatively with 2c%.3.An equation for discriminating AIDH from IDCa was established with the image analysis results.Conclusion The equation is an efficient quantitative index for evaluating the malignant potential of AIDH and the nature of the borderline proliferation lesion.