目的 探讨肿瘤干细胞相关标记物CD44及CD24在乳腺癌组织中的表达特点、CD44+/CD24-细胞与HER-2、ER、PR、CK5/6表达的相互关系及其与临床病理因素的关系.方法 采用免疫组化SP单染及双染法检测42例乳腺导管原位癌及126例乳腺浸润性导管癌组织中CD44及CD24的表达情况,检测126例乳腺浸润性导管癌组织中HER-2、ER、PR、CK5/6表达状况以进行免疫分型.结果 (1)CD44阳性定位于癌细胞膜.在浸润癌中阳性率为56.3%,在导管原位癌中阳性率为85.7%.两者差异有显著性意义(P<0.05).在不同分化程度的乳腺浸润性癌中,CD44阳性率分别为69.2%、58.1%及44.7%,差异有显著性意义(P<0.05).(2)CD24阳性表达于非癌性乳腺组织中小管的腔缘;在癌组织中除腔缘阳性外,可出现膜质阳性.在浸润癌中阳性率为32.5%,在导管原位癌中阳性率为64.3%.两者差异有显著性意义(P<0.05).(3)126例浸润性导管癌中CD44+/CD24-者65例,占51.6%;CD44+/CD24-阳性细胞在Luminal A型为47.5%、Luminal B型为42.9%、HER-2过表达型为13.0%、基细胞型为80.9%.各型间表达差异有显著性意义(P<0.05).Luminal A型、Luminal B型间表达差异无统计学意义(P<0.05).结论 CD44+/CD24-在基底细胞型乳腺癌中具有较高的表达率;CD44+/CD24-在乳腺原位癌中的表达高于浸润性癌,在低分化癌组织中的表达高于高分化癌;CD24由非癌组织的腔缘型向癌组织的膜质型转变提示CD24可能参与肿瘤的发生.%Purpose To explore the characteristics of cancer stem cell-related markers CD44 and CD24 expression in breast cancer, and to investigate the relationship between CD44 + /CD24-~ cells and the expression of HER-2, ER, PR, CK5 / 6, and its correlation with clinical pathological factors. Methods Single and double streptavidin - biotin - peroxidase immunohistochemistry of CD44 and CD24 were performed on 10 cases of breast lobular hyperplasia, 10 cases of simple ductal hyperplasia, 42 cases of ductal carcinoma in situ and 126 cases of breast invasive ductal carcinoma. And Immunohistochemistry of HER-2, ER, PR, CK5 / 6 was used on 126 cases of invasive ductal carcinoma, which the expression of the conditions as immunophenotyping. Results (1) CD44 positive cells located in the membrane. The positive rate was statistically difference between the invasive carcinoma ( 56. 3% ) and the ductal carcinoma in situ( 85. 7% )( P <0. 05 ). In the highly, moderately, poorly differentiation of invasive breast cancer, CD44 positive rates were 69. 2% , 58. 1% and 44. 7% respectively, which differences were significant(P <0. 05 ). ( 2 ) The expression of CD24 was found in luminal border of a tubule of non-cancerous breast tissues, but it was expressed both lumincal border and cytomembrane of cancerous tissues. The positive rate of CD24 in invasive carcinoma was 32. 5% , which was higher than that in ductal carcinoma in situ( 64. 3% , P < 0. 05 ). ( 3 ) Of 126 cases of invasive ductal carcinoma, 65 patients were CD44 + /CD24 ~ ( 51. 6% ), which 47. 5% in the luminal A type,42. 9% in luminal B type, 13.0% in HER-2 overexpression type, and 80.9% for the basal cell type. There was statistical differences among various types( P < 0. 05 ). Conclusions The CD44 + /CD24 ~ phenotype is enriched in basal-like breast tumors. CD44 + /CD24 " cells has a high expression rate of breast carcinoma in situ and poorly differentiated cancer than invasive cancer and well differentiated cancer. The change of CD24 expression from the luminal border in non-cancerous tissues to the cytomembrane in cancerous tissues suggests CD24 may involved in carcinogenesis of breast cancer.
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