摘要
目的:探讨术前核芯针穿刺活检(CNB)免疫组织化学检测ER、PR、C-erbB-2、Ki-67在乳腺癌诊断中的临床应用价值。方法:35例乳腺癌患者术中局部切除肿瘤后,送快速病理前,在手术室中采用巴德枪对肿瘤进行核芯针穿刺取材,模拟术前乳腺癌CNB,取得病理组织学及免疫组织化学检测结果后,与术后病理及免疫组织化学检查结果进行对比。结果:35例乳腺癌患者CNB组织免疫组织化学检测结果与手术切除组织的检测结果对比发现,PR、C-erbB-2和Ki-67表达程度差异无统计学意义(P均>0.05);ER表达程度差异有统计学意义,CNB组织表达的染色强度(数值)整体强于手术切除组织的检测结果(P<0.05),但在定性诊断上两种方法差异无统计学意义(P>0.05,Kappar值=0.8135)。结论:CNB标本免疫组织化学检测不仅可以准确反映乳腺癌肿瘤ER、PR、CerbB-2和Ki-67的定性表达,而且能准确反映乳腺癌PR、C-erbB-2和Ki-67的表达强度。但是,术前CNB标本ER表达强度整体强于术后切除标本,提示采用术前CNB标本检测ER和手术切除标本检测ER对比的方法评价术前化疗、内分泌治疗对乳腺癌ER表达的影响时,应考虑两者之间原本可能存在的差异。
Objective： Study the clinical value of preoperative core needle biopsy（CNB） immunohistochemistry diagnosis of breast cancer.Methods： Thirty-five cases diagnosed breast cancer were collected,after resect the tumor we took the core needle biopsy as inimation of core needle biopsy before surgery.Compare the immunohistochemistry diagnosis between the core needle biopsy tissues and the resected tumor tissues.Results： There is no difference on PR、C-erbB-2 and Ki-67 expression between the core needle biopsy tissues and the resected tumors（P0.05）in 35 cases.The staining intensity of ER is different,there is more ER expression in core needle biopsy tissues than the resected tumor tissues,but no difference in qualitative diagnosis（P0.05,Kappar=0.8135）.Conclusion： Breast cancer core needle biopsy preoperation is accurately in the immunohistochemistry diagnosis of ER,PR,C-erbB-2 and Ki-67.But ER staining intensity is usually stronger in core needle biopsy tissues than in the resected tumor tissues.So,in the research of the neoadjuvant chemotherapy or endocrine therapy effection on ER expression by comparing the ER expression between the core needle biopsy tissues and the resected tumor tissues,the primary difference must be pay enough attention.
出处
《中国现代普通外科进展》
CAS
2011年第7期517-520,共4页
Chinese Journal of Current Advances in General Surgery
基金
山东省自然科学基金资助项目(Q2008C08)
