乳腺癌肿块表面皮肤浸润情况的临床研究

Clinical Study of Inf iltration of Breast Cancer Surface Skin

目的检测乳腺癌肿块表面皮肤浸润情况,从分子水平上探讨乳腺癌肿块表面皮肤乳腺癌细胞浸润的特点,为乳腺癌手术方式、防治复发、乳腺重建等方面提供重要的临床指导。方法应用巢式-逆转录-聚合酶链反应技术检测人乳腺珠蛋白(hMAM)mRNA在15例乳腺增生组织及15例乳腺纤维腺瘤组织及相应表面皮肤中的表达情况,同时检测60例乳腺癌组织及乳腺癌患者肿瘤表面皮肤hMAM mRNA表达,并且分析其表达与年龄、肿瘤直径、腋窝淋巴结转移、肿瘤距乳头中央距离、肿瘤分期的关系。结果乳腺纤维腺瘤组织中hMAM mRNA表达阳性率为40.00%(6/15),乳腺增生组织中为53.33%(8/15),乳腺纤维腺瘤组织及乳腺增生组织表面皮肤均未检出hMAM mRNA表达;60例乳腺癌组织中hMAM mRNA表达阳性率为83.33%(50/60),乳腺癌肿块表面皮肤中检查出3例(5.00%)hMAM mRNA表达阳性。乳腺癌组织中hMAM mRNA表达阳性率较乳腺纤维腺瘤组织及乳腺增生组织明显增高(P<0.05)。乳腺癌肿块表面皮肤中hMAM mRNA表达与患者年龄、肿瘤直径及肿瘤分期无关,但在腋窝淋巴结有转移及肿瘤距乳头中央距离<4 cm患者的乳腺癌肿块表面皮肤中hMAM mRNA表达阳性率明显高于无腋窝淋巴结转移及肿瘤距乳头中央距离≥4 cm者。结论从本组有限的数据结果初步得出,在乳腺癌组织中hMAM mRNA高表达,hMAM mRNA在乳腺癌的皮肤浸润诊断中可能具有一定的价值,在腋窝有淋巴结转移及肿瘤距乳头中央距离<4 cm乳腺癌患者中容易发生肿瘤皮肤浸润。

Objective To study the infiltration situation of breast cancer surface skin, and explore the characteris- tics of infiltration of breast cancer surface skin at the molecular level. Methods Nested reverse transcription-polymerase chain reaction technique was used to detect the expressions of human mammaglobin （hMAM） mRNA in 15 cases of hyper- plasia of mammary gland tissues, 15 cases of breast fibroadenoma tissues, and 60 cases of breast cancer tissues and their corresponding tulnor surface skins. The relationship of the hMAM mRNA expression in the surface skins of breast cancer tissue to its clinicopathologic characteristics was analyzed. Results The hMAM mRNA positive expressions in the breast fibroadenoma tissues, hyperplasia of mammary gland tissues, and breast cancer tissues were 40. 00% （6/15）, 53.33% （8/15）, and 83.33% （50/60）, respectively, which in the breast cancer tissues was significantly higher than that in the breast fibroadenoma tissues or hyperplasia of mammary gland tissues （/9〈0. 05）. There was no hMAM mRNA positive expression in the surface skin of fibroadenoma or hyperplasia of mammary gland tissues, but there was 3 （5.00%） cases of the hMAM mRNA positive expressions in the breast cancer surface skin. The hMAM mRNA positive expression in the breast cancer surface skin was not related with the patient age, tumor diameter, and tumor staging （P〉0. 05）, but was related with axillary lymph nodes metastasis and distance from tumor to nipple less than 4 cm （P〈0. 05）. Conclusions The hMAM mRNA highly expresses in breast cancer tissue and it has a certain value in the diagnosis of infiltration of breast cancer surface skin. The patients with axillary lymph node metastasis and distance from tumor to nipple less than 4 cm are more susceptible to infiltration of breast cancer surface skin.