基底膜和肌上皮细胞在乳腺癌中的形态学变化

CHANGES IN BASEMENT MEMBRANE AND MYOEPITHELIAL CELLS IN BENIGN AND MALIGNANT LESIONS OF BREAST

应用免疫组化法观察110例乳腺良、恶性肿物基底膜(BM)和肌上皮细胞(MEC)的分布情况。结果归纳为三组:(1)良性病变、良性肿瘤及导管内癌和小叶原位癌,BM及MEG完整连续;(2)早期浸润癌,两者呈现中断现象,形成缺口;(3)浸润癌则仅片段阳性或完全消失。以图象分析仪测定腺管或癌巢Ⅳ型胶原阳性段长度占相应腺管或癌巢周径百分比之均值,三组分别为98％,89％和46％或<10％。癌细胞DNA图象分析显示非整倍体细胞数量多少与该导管BM完整性呈负相关。研究表明免疫组化显示的BM和MEG完整与否,是判断乳腺癌是否浸润及浸润程度的良好标志。

Patterns of basement membrane (BM) and myoepithelial cell (MEC) impairment was investigated in 110 cases of benign and malignant lesions of the breasts by means of anti-collagen IV and anti-actin antibody immunohisto-ohemical techniques. The appearance of BM and MEO changes are summarized as follows: (1) An intact pattern was seen in lobular hyperplasia, benign tumors, intraductal carcinoma and lobular carcinoma in situ; (2) disruptive patterns were seen in carcinoma with early microinvasion locally; (3) patterns of fragmentation or absences were seen in invasive carcinomas. Quantitative analyses of the percentage of collagen IV length in ductal circumference examined showed 98 %, 89%, and<46% in above groups respectively. A negative relationship between the an-euploidic DNA content and changes in BM integrity was demonstrated in ductal carcinoma (r=-0.914, P<0.05). These results suggest the distribution patterns of BM aed MEO after staining with immunohistochemical techniques are valubale markers for distinguishing breast carcinoma invasion, especially local invasion in early stages.