摘要
目的:探讨免疫组织化学检测在乳腺病理疾病中的临床诊断作用和准确度。方法:选取2010年7月-2017年12月在本院就诊的乳腺癌患者50例为恶性组和乳腺良性增生患者50例为良性组,其中乳腺癌或良性增生患者标本组织中所带的正常乳腺组织者50例为对照组。三组均接受乳腺穿刺活检或外科手术切除,采集乳腺组织标本。采用免疫组织化学染色技术对组织标本进行染色处理,分析乳腺癌的巨检、镜检、免疫组织化学检测结果,分析各免疫组化检测指标对乳腺癌的诊断准确率,比较三组CK5/6、CK34βE12、EGFR、HER-2、P16、P63、Ki67、PTEN检测结果,分析不同免疫组化检测指标与乳腺癌的相关性。结果:乳腺癌巨检可见肿瘤切面为灰黄色或灰白色,存在边界不清晰的实性区,部分切面可见黄色坏死物;镜检可见乳腺癌细胞呈不规则分布,细胞形态多样,细胞质较少,细胞核级别低,极少核分裂现象,细胞周围可见胶原化或成纤维母细胞增生;免疫组化检测结果显示,50例乳腺癌患者中,CK5/6(+)、CK34βE12(+)、EGFR(+)、HER-2(+)、P16(+)、P63(+)、Ki67(+)、PTEN(-)分别为48、41、45、44、39、40、42、17例,其诊断准确率分别为96%、82%、90%、88%、78%、80%、84%、34%;恶性组CK5/6、CK34βE12、EGFR、HER-2、P16、P63、Ki67阳性率均高于良性组、对照组,PTEN阴性率均低于良性组、对照组,比较差异均有统计学意义(P<0.05);而良性组与对照组免疫组化检测指结果比较,差异均无统计学意义(P>0.05);经相关性分析,CK5/6、CK34βE12、EGFR、HER-2、P16、P63、Ki67的阳性表达与乳腺癌呈正相关(P<0.001),而PTEN阳性表达与乳腺癌呈负相关(P<0.001)。结论:免疫组织化学检测可对不同乳腺病变予以准确鉴别区分,可将免疫组化指标CK5/6、CK34βE12、EGFR、HER-2、P16、P63、Ki67、PTEN等作为乳腺癌生物学行为的辅助判断指标。
Objective：To investigate the clinical diagnostic value and accuracy of immunohistochemistry in breast pathological diseases.Method：A total of 50 patients with breast cancer admitted to our hospital from July 2010 to December 2017 were selected as malignant group and 50 patients with benign breast hyperplasia as benign group,among them,50 cases of normal mammary gland organizer in breast cancer or benign hyperplasia as control group.They underwent breast biopsy or surgical resection,and breast tissue samples were collected.Immunohistochemical staining was used to stain the tissue specimens,the results of giant,microscopic and immunohistochemical detection of breast cancer were analyzed,the diagnostic accuracy of each immunohistochemical detection index for breast cancer was analyzed,the detection results of CK5/6,CK34βE12,EGFR,HER-2,P16,P63,Ki67,PTEN were compared between three groups,the correlation between immunohistochemical markers and breast cancer.Result：There was a lack of clear boundary of breast tissue sections in mammary cancer giant examination,and there was no capsule in tumor tissue,the section was gray yellow or gray white,and there were solid areas.Microscopic examination showed that breast cancer cells were irregular in distribution,various in morphology,few in cytoplasm,low in nuclear grade,few in mitosis,collagenization or proliferation of fibroblasts around the cells.The results of immunohistochemical detection showed that in 50 cases of breast cancer,CK5/6（＋）,CK34βE12（＋）,EGFR（＋）,HER-2（＋）,P16（＋）,P63（＋）,Ki67（＋）,PTEN（-） were 48,41,45,44,39,40,42 and 17 cases respectively,the diagnostic accuracy was 96%,90%,88%,88%,78%,96% respectively.The positive rates of CK5/6,CK34βE12,EGFR,HER-2,P16,P63 and Ki67 in malignant group were all higher than those of benign group and control group,the negative rate of PTEN was lower than that of benign group and control group,the differences were statistically significant（P〈0.05）.The each result of immunohistochemical examination in benign and control groups were compared,the differences were not statistically significant（P〈0.05）.By correlation analysis,the positive expression of CK5/6,CK34βE12,EGFR,HER-2,P16,P63 and Ki67 were positively correlated with breast cancer（P〈0.001）,but the positive expression of PTEN was negatively correlated with breast cancer（P〈0.001）.Conclusion：Immunohistochemical examination can be used to distinguish the different breast lesions accurately,and the immunohistochemical index CK5/6,CK34βE12,EGFR,HER-2,P16,P63,Ki67,PTEN and so on may be used as an auxiliary index to judge the biological behavior of breast cancer.
作者
杨丽英
朱杰
YANG Liying;ZHU Jie(The First People＇s Hospital of Honghe Prefecture,Mengzi 661199,China)
出处
《中国医学创新》
CAS
2018年第13期10-13,共4页
Medical Innovation of China
关键词
乳腺癌
诊断
免疫组织化学
Breast cancer
Diagnosis
Immunohistochemistry
