乳腺导管内癌分子分型及其与组织学分级、Ki-67指数的相关性研究

摘要

Objective To investigate the correlation of molecular subtyping and pathological factors,Ki-67 in the ductal carcinoma in situ (DCIS).Methods Pathological data of 57 DCIS patients received retrospective analysis,the ER、PR、HER-2 and Ki-67 were detected by immunohistochemical,the histological differentiation were detected by HE.Results Luminal A sub-type,Luminal B subtype,HER-2 overexpression subtype and normal subtype was 26 case(45.61%),17 case(29.82%),11 case (19.30%),3 case(5.27%) in DCIS,respectively.Compared with invasive ductal carcinoma (IDC),the Luminal A subtype and normal subtype had significant difference.Furthermore,the high grade of DCIS accounted for 26.9% of the Luminal A subtype, lower than other subtype.The expression of Ki-67 in Luminal A subtype was lower than the other subtype.Conclusion The sub-type of DCIS are Luminal subtype,especially Luminal A subtype with good prognosis.All of HER-2 overexpression subtype and normal subtype are high grade and high index of Ki-67,indicate that the risk of progress to IDC is high.%目的：探讨乳腺导管内癌分子分型及其与组织学分级、Ki-67指数的关系。方法回顾性分析了57例乳腺导管内癌患者的病理资料，根据免疫组化进行分子分型，并观察其与组织学分级及Ki-67等指标的关系。结果57例乳腺导管内癌中腺腔A型26例（45．61％），腺腔B型17例（29．82％），HER-2过表达型11例（19．30％）；三阴性型3例（5．27％）。乳腺导管内癌与浸润性导管癌比较，腺腔A型和三阴性型所占比例存在显著性差异；乳腺导管内癌高级别在腺腔型尤其是腺腔A型中所占比例较低，而Her-2过表达型及三阴性型乳腺癌全部为高级别。但高级别乳腺导管内癌与浸润性导管癌的分子分型基本一致。最后发现腺腔A型乳腺导管内癌中Ki-67表达水平最低，Her-2过表达型和三阴性型乳腺导管内癌中Ki-67指数相对较高。结论乳腺导管内癌大部分患者为腺腔型（尤其是腺腔A型），腺腔型（尤其是腺腔A型）预后较好，而HER-2过表达型及三阴性型全部为高级别乳腺导管内癌，Ki-67指数较高，预示其发展为浸润癌的风险较高。