乳腺浸润性导管癌钙化与人表皮生长因子受体-2及细胞增殖抗原Ki67关系

Relationship of calcification with human epidermal growth factor receptor-2 and Ki67 in breast invasive ductal carcinoma

目的探讨乳腺浸润性导管癌钙化与人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)及细胞增殖抗原Ki67间的关系。方法术前穿刺活检或术中冰冻组织病理证实乳腺浸润性导管癌者237例,术后均常规行免疫组织化学检查,依据术前钼靶X线将患者分为钙化组和无钙化组,比较2组HER-2、Ki67阳性表达率;分析不同钙化形态、分布及有无肿块者乳腺癌组织中HER-2、Ki67阳性表达率。结果237例中HER-2阳性表达率为56.12%,Ki67阳性表达率为67.93%;钼靶X线显示乳腺钙化者98例,无钙化者139例;钙化组HER-2阳性表达率(64.29%)高于无钙化组(50.36%),Ki67阳性表达率(53.06%)低于无钙化组(78.42%),差异均有统计学意义(P<0.05);泥砂样钙化组、蠕虫样钙化组、其他钙化组HER-2阳性表达率分别为62.32%、85.71%及25.00%、Ki67阳性表达率分别为63.77%、23.81%及37.50%,3组间比较差异有统计学意义(P<0.05);钙化灶弥漫、区段、成簇分布者HER-2、Ki67表达阳性率比较差异无统计学意义(P>0.05);钙化伴肿块者与未伴肿块者HER-2、Ki67表达阳性率比较差异无统计学意义(P>0.05)。结论乳腺浸润性导管癌组织HER-2、Ki67阳性表达率与病灶钙化及钙化灶形态有关。

Objective To explore the relationship of calcification with human epidermal growth factor receptor-2 （HER 2） and proliferating antigen Ki67 in breast invasive ductal carcinoma. Methods A total of 237 patients with breast invasive ductal carcinoma confirmed by preoperative biopsy or intraoperative frozen pathology underwent postoperative immunohistochemistry. The patients were divided into calcification group and non calcification group according to mammography X-ray results. The positive rates of HER-2 and Ki67 were compared between two groups and analyzed among the patients with different morphology or distribution of calcification and whether or not complicated with breast mass. Results The positive rates of HER-2 and Ki67 were 56. 12% and 67.93% in 237 patients. Mammography X-ray results revealed calcification in 98 patients and no calcification in 139 patients. The positive rate of HER-2 was significantly higher and the positive rate of Ki67 was significantly lower in calcification group （64.29%, 53.06 %） than those in non-calcification group （50.36%, 78.42%） （P〈0.05）. The positive rates of HER-2 in sediment calcification group, worm-like calcification group and other type calcification group were 62. 32%, 85. 71% and 25. 00%, and the positive rates of Ki67 were 63. 77%, 23. 81% and 37. 50%, showing significant differences among three groups （P〈 0.05）. There were no significant differences in the positive rates of Ki67 and HER-2 in diffuse, sector and clusters distribution groups （P〈0.05）. There were no significant differences in the positive rates of Ki67 and HER-2 between the patients complicated with breast mass and those not complicated with breast mass （P〈0.05）. Conclusion The positive rates of HER-2 and Ki67 are correlated with the occurrence and morphology of calcification in patients with breast invasive ductal carcinoma.