免疫组织化学在乳腺癌鉴别诊断中的临床意义

Significance of Immunohistochemistry in the Differential Diagnosis of Breast Cancer

目的探讨免疫组织化学法在乳腺癌鉴别诊断中的临床意义。方法对江油市人民医院病理科2006年1月至2013年9月收治的852例浸润性乳腺癌组织标本进行链霉菌抗生物素蛋白-过氧化物酶连结法检测。比较不同年龄(≤50岁359例、>50岁493例),不同肿瘤最大直径(T)(T≤2 cm 395例、2 cm<T≤5 cm 401例、T>5 cm 56例),不同临床分期(Ⅰ期251例、Ⅱ期346例、Ⅲ期158例、Ⅳ期97例)的孕激素受体(PR)、雌激素受体(ER)、C-erb B-2、血管内皮生长因子(VEGF)、p53和Ki-67的阳性率。结果PR阳性率在低年龄组(58.77%)、肿瘤T≤2 cm(60.00%)、临床分期早较高且差异均有统计学意义(P<0.05);肿瘤T≤2 cm,ER阳性率(68.35%)显著高于其他肿瘤大小组(P<0.01),不同年龄、临床分期的阳性率差异无统计学意义(P>0.05),C-erb B-2在肿瘤大小、临床分期的阳性率差异均有统计学意义(P<0.05);VEGF、p53和Ki-67在不同年龄组、肿瘤体积组、临床分期的阳性率差异均无统计学意义(均P>0.05)。结论免疫组织化学指标中PR、ER、C-erb B-2在乳腺癌鉴别诊断中具有重要指导意义,可用于临床上鉴别诊断乳腺癌。

Objective To investigate the clinical significance of immunohistochemistry in the differential diagnosis of breast cancer,and provide reference for clinical differential diagnosis. Methods A total of 852 invasive breast cancer tissue specimens from Jiangyou City People＇ s Hospital from Jan. 2006 to Sep. 2013 were done immunohistochemical staining Streptavidin-Perosidase（ the SP） assay. The positive rates of progesterone receptor（ PR）,estrogen receptor（ ER）,C-er B-2,vascular endothelial growth factor（ VEGF）,p53 and Ki-67 between different age groups（ ≤50 years dd 359 cases, 〉50 years dd 493 cases）,differe tumor maximun size groups（ T≤2 cm 395 cases,2 cm T≤5 cm 401 cases,T〉5 cm 56 cases） and different clinical stage groups（ stageⅠ251 cases,stage Ⅱ 346 cases,stage Ⅲ 158 cases,stage Ⅳ 97 cases）were compared respectivcly. Results PR-positive rate（ 58. 77%）,tumor size ≤2 cm（ 60. 00%）,early clinical stage in the lower age group were high and the differences were statistically significant（ P〈0. 05）;ER-positive rate（ 68. 35%） of the tumor T ≤2 cm group was significantly higher than other tumor size groups（ P〈0. 01）,positive rate of different age,clinical stage groups was not statistically significantly different（ P〉0. 05）; C-erb B-2 positive rate in different tumor size groups,different clinical stage groups were statistically significantly different（ P〈0. 05）; VEGF,p53 and Ki-67 positive rate in different age groups,different tumor size groups,and different clinical stage groups was not statistically significantly different（ all P〉0. 05）. Conclusion The PR,ER,C-erb B-2 immunohistochemistry index have great significance in differential diagnosis of breast cancer and can be used in clinical.