免疫组织化学在乳腺普通型与不典型导管增生诊断中的意义

摘要

目的 探讨细胞角蛋白(CK)5 、CK5/6 、CK34βE12 、雌激素受体(ER)及孕激素受体(PR)在乳腺普通型导管增生(UDH)与不典型导管增生(ADH)中的表达及应用意义.方法 选取115例 UDH 和42例ADH ,采用免疫组织化学EnVision二步法检测CK5 、CK5/6 、CK34βE12 、ER和PR的表达.结果 CK5 、CK5/6 、CK34βE12阳性率在UDH分别为98.3%、94.8%、97.4%,在ADH分别为40.5%、54.8%、52.4%,在UDH的表达高于 ADH (χ2 值分别为 72.14 、36.80 、49.85 ,均 P＜0.01). ER与 PR在 UDH 主要呈不均一性阳性(87.8%、84.4%) ,在ADH主要呈均一性强阳性或阴性(54.76%、52.38%) ,两者差异有统计学意义(χ2 值分别为30.98 、21.86 ,均P＜0.01) .结论 CK5 、CK5/6 、CK34βE12 、ER及PR可作为UDH和ADH诊断与鉴别诊断的客观辅助指标,联合检测对准确诊断UDH与ADH有重要意义.%Objective To investigate the expressions of CK5 ,CK5/6 ,CK34βE12 ,ER and PR in usual duc-tal hyperplasia(UDH) and atypical ductal hyperplasia(ADH) of the breast and their significance .Methods Immu-nohistochemical staining (EnVision method) was performed to detect the expression of CK 5 ,CK5/6 ,CK34βE12 , ER and PR in 115 cases of UDH and 42 cases of ADH .Results The positive rate of CK5 ,CK5/6 and CK34βE12 in UDH was 98 .3%,94 .8% and 97 .4%,respectively .But in ADH was 40 .5%,54 .8% and 52 .4%,respective-ly .The expression of CK5 ,CK5/6 and CK34βE12 were higher in UDH than in ADH(χ2 value was 72 .14 ,36 .80 and 49 .85 ,respectively ,all P＜0 .01).ER and PR presented variable positive expression in UDH but homogene-ously strong positive or negative expression in ADH (χ2 value was 30 .98 and 21 .86 ,respectively ,both P＜0 .01). Conclusion CK5 ,CK5/6 ,CK34βE12 ,ER and PR can be considered as useful indexes in differential diagnosis of UDH and ADH .