乳腺导管癌中微浸润癌细胞的病理形态学特征

Pathomorphological Features of Microinvasive Cancer Cells in Breast Ductal Carcinoma

目的:探讨乳腺导管癌患者中微浸润癌细胞的病理形态学特征。方法:回顾性分析我院2012年6月-2014年6月收治的60例可手术治疗的微浸润乳腺导管癌患者的临床资料,将微浸润癌细胞作为观察对象,同一导管内其它癌细胞作为对照,采用双重免疫组化(SP)法检测肿瘤侵袭指标、抑制凋亡因子的表达,采用Pearson相关分析研究各指标的相关性,并描述细胞病理形态。结果:观察组TIMP-1和MMP-9的阳性表达率分别为6.7%(4/60)和11.7%(7/60),显著低于对照组的70.0%(42/60)和63.3%(38/60),p16的阳性表达率13.3%(8/60)显著低于对照组的73.3%(44/60),Bcl-2的阳性表达率6.7%(10/60)也显著低于对照组的66.7%(40/60),而cerb-B2的阳性表达率71.7%(43/60)显著高于对照组36.7%(22/60),差异均具有统计学意义(均P<0.05);微浸润癌细胞中TIMP-1和MMP-9呈正相关,相关系数r=0.723,MMP-9和Bcl-2无相关性,Bcl-2和p16也无正相关;微浸润癌细胞多数呈深染浓缩的卵圆形或不规则形,并以舌形或锥形侵入基底。结论:微浸润癌细胞多处于分化程度低的幼稚甚至原始细胞状态,具有潜在浸润能力。

Objective. To explore pathomorphological features of microinvasive cancer cells in patients with breast ductal carcinoma. Methods： Clinical data of 60 patients with breast ductal carcinoma were retrospectively analyzed, and microinvasive cancer cells were studied and compared with other cancer cells in the same catheter. Double immunohistochemical method （SP） was adopted to detect tumor invasion factors and inhibitors of apoptosis factors, and describe pathological morphology of ceils. Results： Positive expression rates of TIMP-1 and MMP-9 were 6. 7% （4/60） and 11.7 % （7/60） in microinvasive cancer group, significantly lower than those in control group, which were 70.0% （42/60） and 63. 3% respectively （38/60）. P16 positive expression rate of 13.3% （8/60） was significantly lower than that in control group, which was 73.3% （44/60）. Bcl-2 positive expression rate of 6.7% （10/60） was also significantly lower than that in control group,which was 66.7% （40/60）. While cerb-B2 positive expression rate of 71.7% （43/60） was significantly higher than that in control group, which was 36.7% （22/60）. The differences were statistically significant （P〈0.05）. Conclusion： Invasive cancer cells usually locate in the low degree of differentiated naive or primitive cells with potential invasive capability.