摘要
目的：探讨各种乳腺癌前病变与乳腺癌发生的关系。方法：应用全乳腺大切片技术结合ＣＥＡ、ｃ－ｅｒｂＢ－２癌基因产物免疫组化检测及流式细胞术（ＦＣＭ）测定ＤＮＡ含量、Ｓ期细胞比率（ＳＰＦ）和细胞增殖指数（ＰＩ），对３９３例乳腺癌标本进行癌旁和癌前病变与乳腺癌相关性的多指标综合研究。结果：乳腺癌最多见的癌旁病变是导管上皮增生（５５．２％），其次为囊性增生病（５３．４％）和乳头状瘤病（２２．２％）。其中与乳腺癌关系较密切的癌前病变是导管上皮增生和乳头状瘤病。通过多指标检测证实，导管上皮重度不典型增生和重度乳头状瘤病是与乳腺癌最密切相关的癌前病变，其中２９．３％有１～２项检测指标呈高水平表达的病变，应视为可疑早期癌，１２．２％有２项以上指标呈高水平表达的病变应按早期乳腺癌对待。结论：对癌前病变特别是导管上皮重度不典型增生和重度乳头状瘤病进行ＣＥＡ、ｃ－ｅｒｂＢ－２癌基因及ＦＣＭ分析等多项指标检测，有利于发现早期乳腺癌，并将为乳腺癌的病理学早期诊断提供新的重要依据。
Immunohistochemical staining of 393 cases of whole breast sections for carcinoembryonic antigen (CEA) , c erbB 2 oncogene product as well as flow cytometry (FCM) assaying for DNA content, S phase fraction and proliferation index were performed in order to study the correlation between cancer and neighboring precancerous lesion of the breast. The most common lesions in the neighborhood of cancer was ductal epithelial hyperplasia in 55.2% of cases followed by cystic hyperplasia (53.4%) and papillomatosis (22.2%). It was found that ductal epithelial hyperplasia and papillomatosis were closely related with cancer with severe atypical hyperplasia of the ductal epithelium and severe papillomatosis in particular. High level expression of one or two of these parameters was observed in 29.3% of the cases which should be regarded as suspicious early cancer.In case when three or more of these parameters were found (12.2%) early breast cancer is highly probable. Multiple parameter detection is useful for identification of precancerous lesion and may provide important evidence for the diagnosis of early breast cancer.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
1999年第1期2-7,共6页
Chinese Journal of Clinical Oncology
基金
天津市科委"八五"攻关项目基金
关键词
乳腺癌
癌前病变
癌胚抗原
C-ERBB-2癌基因
Breast cancer Precancetrous lesion Whole breast section Carcinoembryonic antigen C erbB 2 oncogene Flow cytometry
