【摘要】 目的 探讨乳腺浸润性导管癌中表皮钙黏蛋白（E-cadherin，E-cad）的表达及其意义。 方法 选取2005年1月－2009年12月的组织病理切块，用免疫组织化学EnVision二步法检测63例乳腺浸润性导管癌（invasive ductal carcinoma，IDC）组织中E-cad的表达情况，设为IDC组；另检测15例乳腺纤维腺瘤及15例乳腺小叶增生症乳腺组织中E-cad的表达情况，设为对照组；比较两组的E-cad表达。 结果 E-cad在IDC组及对照组中表达阳性率分别为58.7%、80.0%；两组间差异有统计学意义（Plt;0.05）。在乳腺IDC患者中，年龄lt;38岁和≥38岁组的E-cad阳性表达率分别是54.2%、61.5%，两组间差异无统计学意义（Pgt;0.05）；肿块直径lt;3 cm和≥3 cm组的E-cad阳性表达率分别是54.8%、66.7%，两组间差异无统计学意义（Pgt;0.05）；组织学分级为Ⅰ+Ⅱ级和Ⅲ级组的E-cad阳性表达率分别是76.3%、32.0%，两组间差异有统计学意义（Plt;0.05）；无、有腋窝淋巴结转移组的E-cad阳性表达率分别是78.3%、47.5%，两组间差异有统计学意义（Plt;0.05）。 结论 E-cad的表达与患者年龄及肿块大小无关，而与组织学分级、淋巴结转移相关。在乳腺浸润性导管癌中，无淋巴结转移者E-cad表达高于有淋巴结转移者，提示E-cad是乳腺浸润性导管癌发生淋巴结转移的重要指标。【Abstract】 Objective To explore the expression of the protein E-cadherin (E-cad) in invasive ductal carcinoma (IDC) of the breast and its significance. Methods We chose 63 cases of pathological wax with IDC between 2005 and 2009, and immunohistochemical EnVision method was used to detect the expression of E-cad protein in these cases which were designated to be the IDC group. At the same time, the E-cad expression in 15 cases of breast adenoma and another 15 cases of breast lobular hyperplasia were also detected, and these cases were designed to the the control group. The expression of E-cad in these two groups were compared. Results The positive rates of E-cad protein expression in the IDC group and the control group were respectively 58.7% and 80.0% with a significant difference between the two groups (Plt;0.05). In the IDC group, the positive rates of E-cad protein expression in patients agedlt;38 and ≥38 years old were respectively 54.2% and 61.5% without a significant difference (Pgt;0.05). The positive rates of E-cad protein expression for tumors with a diameter lt;3 cm and ≥3 cm were respectively 54.8% and 66.7% without a significant difference (Pgt;0.05). The positive rates of E-cad protein expression for class Ⅰ+Ⅱ tumors and class Ⅲ tumors were respectively 76.3% and 32.0% with a significant difference (Plt;0.05). The positive rates of E-cad protein expression for patients without and with axillary lymph node metastasis were respectively 78.3% and 47.5% with a significant difference (Plt;0.05). Conclusions The expression of E-cad is correlated with histological classification and lymph node metastasis and was not related to tumor size and age of the patients. The expression of E-cad is higher in IDC patients without lymph node metastasis than that in IDC patients with lymph node metastasis, which indicates that E-cad is an important index for lymph node metastasis of IDC.
ObjectiveTo investigate the relationship of dynamic contrast enhanced(DCE) MRI scan of the mass type of invasive ductal breast cancer to histological grade. MethodThe imagings of DCEMRI of 92 patients confirmed with operation or biopsy pathology and its correlation with WHO histological grade were analyzed. ResultsThere were 29(31.52%) patients with the tumor long diameter≤2 cm, 53(57.61%) 2-5 cm, 10(10.87%)≥5 cm. There were 3(3.26%) patients with round of the morphological lesions, 7(7.61%) oval, 33(35.87%) lobulated shape, 49(53.26%) irregular shape. There were 11 (11.96%) patients with smooth margin of the periphery of the lesions, 47 (51.09%) irregular shape, 34(36.96%) spiculate margin. There were 15(16.30%) patients with homogeneous enhancement, 40(43.48%) heterogeneous enhancement, 37(40.22%) ring-like enhancement. WHO pathological grade:grade 1 was in 5 cases(5.43%), grade 2 in 30 cases(32.61%), grade 3 in 57 cases(61.96%). The statistical results showed that MRI dynamic enhancement characteristics of lesions in size, shape, and enhanced features were correlated with WHO pathological grade (P < 0.05), there was no correlation between the edge features of the tumor and WHO histological grade(P > 0.05). ConclusionThere is a certain correlation between the breast cancer enhanced MRI features and WHO histological grade, which can be evaluated biological behavior and prognosis according to MRI signs of lesions.
ObjectiveTo study the mechanism of reducing the intratumoral microvessel density (MVD) by Ginsenoside Rg3 (Rg3) combined with cytotoxic agent in xenotransplanted human breast infiltrating duct carcinoma in nude mice. MethodsSixteen female nude mice were randomly divided into 4 groups to receive cyclophosphamid (16 mg/kg,qd) combined with Rg3 (10 mg/kg, qd),Rg3(10 mg/kg,qd) alone,cyclophosphamid (16 mg/kg,qd) alone and 0.5% sodium carboxymethyl cellulose (0.5 ml,qd) respectively for 55 days. Breast cancer mass were weighed and sampled for light microscopic observation. The intratumor MVD was examined by immunohistochemical staining. ResultsThe tumor weight of treated group was significantly lower than that of control group. The tumor weight of the Rg3 combined with CTX group was lower than that of Rg3 group. The MVD value of Rg3 group was significantly lower than that of CTX group and control group. The MVD was significantly reduced in the Rg3 combined with CTX group than that in the others.ConclusionRg3 combined with CTX can inhibit the growth of xenotransplanted human breast infiltrating duct carcinoma, and reduce the intratumoral MVD.
ObjectiveTo investigate the expressions of Snail and VEGF gene in invasion ductal carcinoma tissues and analyze their clinicopathologic relationship. MethodsThe expressions of Snail and VEGF gene were detected on mammary gland hyperplasia (30 cases), intraductal breast cancer (30 cases), and invasion ductal carcinoma (70 cases) by in situ hybridization， to compare with the expression difference of the two genes in the different pathological changed tissues of mammary gland and among the clinicopathological facters of invasion ductal carcinoma as well as the relationship. ResultsThe expression rate of Snai mRNA in mammary gland hyperplasia， intraductal breast cancer, and invasion ductal carcinoma was 23.3% (7/30)， 46.7% (14/30), and 81.4% (57/70), respectively, there was statistical difference among them (χ 2=32.4, Plt;0.05)； The expression rate of VEGF mRNA in mammary gland hyperplasia， intraductal breast cancer, and invasion ductal carcinoma was 33.3% (10/30)， 50.0% (15/30), and 71.4% (50/70), respectively, there was statistical difference among them (χ 2=13.4, Plt;0.05). The expression rates of Snail mRNA and VEGF mRNA in lymphatic metatasis group were significantly higher than those in no lymphatic metatasis group 〔92.7% (38/41) vs. 65.5% (19/29)， χ 2=8.29, Plt;0.05； 85.4% (35/41) vs. 51.7% (15/29), χ 2=9.42, Plt;0.05， respectively 〕. The expression rates of Snail mRNA and VEGF mRNA in Ⅲ-Ⅳ stage of TNM clinical stage were significantly higher than those in Ⅰ-Ⅱ stage 〔939% (46/49) vs. 52.4% (11/21), χ 2=14.14， Plt;0.05； 81.6% (40/49) vs. 47.6% (10/21), χ 2=8.32， Plt;0.05〕. The expressions of Snail mRNA and VEGF mRNA were related to the expressions of ER, PR, HER-2, and vessel cancer embolus （Plt;0.01）. The expressions of Snail mRNA and VEGF mRNA were not related to age, tumor size, and histological grade (Pgt;0.05). There was a positive correlation between the expressions of Snail mRNA and VEGF mRNA （r=0.67， Plt;0.05）. ConclusionsThe overexpressions of Snail mRNA and VEGF mRNA in invasion ductal carcinoma has a synergetic effect on occurrence and development, therefore, combined detecting the expressions of Snail mRNA and VEGF mRNA are some significance to predict infiltration and metastasis of the invasion ductal carcinoma.
Objective To assess the clinical efficacy of neoadjuvant chemotherapy （NAC） for breast invasive ductal carcinoma with MR diffusion weighted imaging. Methods Thirty patients with breast invasive ductal carcinoma underwent conventional MRI scanning and diffusion weighted imaging examination before and after preoperative neoadj-uvant chemotherapy. Two experienced radiologists independently analyzed and measured the maximum lesion diameter and apparent diffusion coefficient （ADC） values before and after treatment，respectively. Statistical analysis was performed for testing the tumor maximum diameter and ADC values change by using the paired t-test. Results After NAC treatment，the maximum tumor diameter of invasive ductal breast carcinoma sharply reduced〔（4.33±0.83） cm vs. （2.04±0.64） cm，P＜0.001〕. When b value was 1 000，the mean ADC values of breast massess were significantly changed after NAC treatment〔（1.89±0.15） ×10-3mm2/s vs. （1.14±0.31） ×10-3mm2/s， P＜0.05〕. Conclusion MR diffusion weighted imaging can non-invasively and accurately assess the NAC efficacy， which are helpful for making surgical strategies.
ObjectiveTo investigate the clinicopathological features, diagnosis and treatment of invasive micropapillary carcinoma (IMPC) of the breast.MethodThe relevant literatures at home and abroad in recent years about the clinical features, pathological features and diagnosis and treatment of IMPC were reviewed.ResultsIMPC is in low incidence and mostly in mixture. Because the clinical manifestations of IMPC and invasive ductal carcinoma of breast are basically similar, only the typical pathological features in pathological examination can confirm the diagnosis as " inside-out growth pattern” and " morula-like clusters of cancer cells surrounded by clear stromal spaces”.ConclusionsIMPC is a special subtype of breast invasive carcinoma, which should be pay enough attention to it in clinic due to its unique microscopic morphology, high vessel invasiveness and high lymph node metastasis rate, high malignancy, poor prognosis and so on.
Objective To investigate the proportions of CD4+ T cells, CD8+ T cells, and mutant of p53 gene in the microenvironment of breast infiltrating ductal carcinoma, and to explore its’ correlation with prognosis of breast infiltrating ductal carcinoma. Methods Eighty-five cases of breast infiltrating ductal carcinoma were collected who underwent surgery in the 371st Central Hospital of Peoples’ Liberation Army from 2010 to 2012, and then detected the proportion of CD4+ T cells and CD8+ T cells, ratio of CD4+ T cells to CD8+ T cells, and mutant of p53 gene in the cancer tissues with immunohistochemistry. Comparison between the sentinel lymph node metastasis group and non-sentinel lymph node metastasis group, mutant of p53 gene group and non-mutant of p53 gene group on the proportions of CD4+ T cells, CD8+ T cells, and ratio of CD4+ T cells to CD8+ T cells were performed, as well as the relationship between proportion of CD8+ T cells/mutant of p53 gene and prognosis of breast infiltrating ductal carcinoma. Results ① The relationship between proportion of CD4+ T cells/proportion of CD8+ T cells/ratio of CD4+ T cells to CD8+ T cells and situation of sentinel lymph node metastasis: at cluster, compared with the sentinel lymph node metastasis group, the proportion of CD8+ T cells was lower in the non-sentinel lymph node metastasis group (P<0.05), but there was no significant difference on the proportion of CD4+ T cells and ratio of CD4+ T cells to CD8+ T cells (P>0.05); at stroma, compared with the sentinel lymph node metastasis group, the proportions of CD4+ T cells and CD8+ T cells were lower, but the ratio of CD4+ T cells to CD8+ T cells was higher in the non-sentinel lymph node metastasis group (P<0.05). ② The relationship between proportion of CD4+ T cells/proportion of CD8+ T cells/ratio of CD4+ T cells to CD8+ T cells and mutant of p53 gene: both at the cluster and stroma, compared with the mutant of p53 gene group, the proportions of CD4+ T cells and CD8+ T cells were lower, but the ratio of CD4+ T cells to CD8+ T cells was higher in the non-mutant of p53 gene group (P<0.05). ③ The relationship between proportion of CD8+ T cells/mutant of p53 gene and prognosis of breast infiltrating ductal carcinoma: the prognosis was worse in patients with high degree of infiltration of CD8+ T cells and mutant of p53 gene than those patients with low degree of infiltration of CD8+ T cells and non-mutant of p53 gene (P<0.05). Conclusions The proportions of CD4+ T cells and CD8+ T cells, and ratio of CD4+ T cells to CD8+ T cells are associated with the situation of sentinel lymph node metastasis and mutant of p53 gene, and the degree of infiltration of CD8+ T cells and mutant of p53 gene are associated with the prognosis of breast infiltrating ductal carcinoma.
ObjectiveTo study the expressions of cyclooxygenase-2(COX-2) and Ki-67 in the invasive ductal carcinoma (IDC) of breast and to analyze its clinical significance. MethodsImmunohistochemical SP method was performed to detect the expressions of COX-2 and Ki-67 in 82 cases of IDC of breast and corresponding tumor-adjacent normal breast tissues, and the relationship of these expressions to clinicopathologic characteristics was analyzed. Results①The positive rates of COX-2 and Ki-67 protein expressions in the IDC of breast tissues were significantly higher than those in the corresponding tumor-adjacent normal breast tissue [COX-2:71.95%(59/82) versus 8.54%(7/82), χ2=68.56, P < 0.001;Ki-67:64.63%(53/82) versus 13.42%(11/82), χ2=45.20, P < 0.001].②The positive rates of COX-2 and Ki-67 protein expressions were positively correlated with TNM staging (COX-2:rs=0.349, P < 0.05;Ki-67:rs=0.305, P < 0.05), lymph node metastasis (COX-2:rs=0.336, P < 0.05;Ki-67:rs=0.419, P < 0.01), vascular invasion (COX-2:rs=0.235, P < 0.05;Ki-67:rs=0.461, P < 0.01), and histological grade (COX-2:rs=0.434, P < 0.01;Ki-67:rs=0.378, P < 0.05).The positive rate of Ki-67 protein expression was positively correlated with tumor diameter (rs=0.365, P < 0.01), but the positive rate of COX-2 protein expression wasn't correlated with it (rs=0.135, P > 0.05).The positive rates of COX-2 and Ki-67 protein expressions weren't correlated with menstrual status (COX-2:rs=0.172, P > 0.05;Ki-67:rs=0.163, P > 0.05).③The positive rate of COX expression was positively correlated with the positive rate of ki-67 expression (rs=0.475, P < 0.01). ConclusionsThere are high-expressions of COX-2 and Ki-67 in IDC of breast.COX-2 and Ki-67 are significantly correlated with the clinicopathologic characteristics in IDC of breast.Combined detection of COX-2 and Ki-67 might calculate the biological behaviors of IDC of breast.COX-2 might be a target of molecular targeted therapy to breast cancer.
Objective To investigate expressions of EphA2 and EphrinA1 in invasive ductal carcinoma of breast and to explore their clinical significances. Method The protein and mRNA expressions of EphA2 and EphrinA1 in 30 breast fibroma tissues, 30 breast cystic hyperplasia tissues, and 100 invasive ductal carcinoma of breast tissues were detected by immunohistochemistry andin situ hybridization respectively, and correlation between them and relations between their expressions in invasive ductal carcinoma of breast tissues and clinicopathologic factors were analyzed. Results ① The results of the immunohistochemistry andin situ hybridization tests showed that the protein and mRNA expressions of EphA2 and EphrinA1 in the invasive ductal carcinoma of breast tissues were significantly higher than those in the breast fibroma tissue (P<0.001) and breast cystic hyperplasia tissue (P<0.001). ② The positive expressions of EphA2 and EphrinA1 protein and mRNA were associated with the lymph node metastasis, histological grade, and TNM stage (P<0.05), in other words, which in the invasive ductal carcinoma of breast patients with lymph node metastasis, high histological grade, and high TNM stage were higher. However, which were not associated with the age and the tumor diameter (P>0.05). ③ The positive protein expressions or positive mRNA expressions in the invasive ductal carcinoma of breast tissues all had positive correlations between the EphA2 and the EphrinA1 (protein:rs =0.999,P<0.01; mRNA:rs =0.942,P<0.01). Conclusions EphA2 and EphrinA1 might be involved in carcinogenesis and development procedures of invasive ductal carcinoma of breast. Combined detection of EphA2 and EphrinA1 could help to predict clinical and pathologic characteristics of invasive ductal carcinoma of breast. They might provide a new target for clinical medication, prognosis, and targeted therapy.