Relationship of a new histological categorization of ductal carcinoma in situ of the breast with size and the immunohistochemical expression of p53, c-erb B2, bcl-2, and ki-67
Relationship of a new histological categorization of ductal carcinoma in situ of the breast with size and the immunohistochemical expression of p53, c-erb B2, bcl-2, and ki-67
复制标题
DOI：
10.1016/s0046-8177(97)90014-9
复制
发表时间：
1997-08-01
期刊：
影响因子：
3.3
通讯作者：
OMalley, FP
中科院分区：
文献类型：
--
作者：
Mack, L;Kerkvliet, N;OMalley, FP
导管原位癌（DCIS）是一种异质性的疾病。对于不同细胞学和建筑学类型的DCIS，目前还没有公认的分类。最近的一项研究（Scott et al, 1995）表明，超过90%的DCIS可以很容易地分为以下五类：高级别（HG）、中级别（IG）、低级别（LG）、纯微乳头状(M)和纯大汗液(A)。本研究的目的是确定病变大小与p53、c- erbb B2、bcl-2和ki67的免疫组化表达之间是否存在关系。1984年至1995年间诊断的70例DCIS病例来自安大略省伦敦两所教学医院的病理科。对原始切片进行回顾，根据Scott等人（1995）进行分类，并对具有代表性的切片进行免疫组织化学（MC）研究。采用先前描述的半定量评分系统对免疫组化染色进行评分（Allred等，1993）。如果病变可触及，则从大体测量中取尺寸；对于不可触及的病例，则记录为组织学切片上测量的最大尺寸。70例DCIS中，HG 17例（24.3%），IG 23例（32.9%），LG 21例（30%），纯微乳头状DCIS 7例（10%），纯顶泌DCIS 2例（2.9%）。各亚类DCIS的平均大小差异有统计学意义（P = 0.008）。特别是，微乳头状DCIS病例最大（平均大小为17mm）。c- erbb B2的平均免疫组化评分在各类别中也有统计学差异（P = .007），而p53和ki67的平均评分在各类别中有统计学差异（P = .073, P = .062）。bcl-2平均评分与各亚类间无显著差异。已知DCIS的大小和c- erbb B2阳性分别与更积极的临床行为和更晚期的组织学特征相关。由于这种组合的组织学细胞学分类系统可以预测大小和c- erbb B2阳性，我们的研究结果支持这种分类系统的临床相关性。版权所有(C) 1997由W.B. Saunders公司。
Ductal carcinoma in situ (DCIS) represents a heterogeneous group of diseases. There is no generally accepted classification for the different cytological and architectural types of DCIS. A recent study (Scott et al, 1995) indicates that over 90% of DCIS can be easily classified into the following five categories: high grade (HG), intermediate grade (IG), low grade (LG), pure micropapillary (M), and pure apocrine (A). The aim of this study was to determine if there is a relationship between lesion size and the immunohistochemical expression of p53, c-erb B2, bcl-2, and ki67 with this reproducible categorization of DCIS. Seventy cases of DCIS diagnosed between 1984 and 1995 were obtained from the Departments of pathology at two teaching hospitals in London, Ontario. The original sections were reviewed, classified according to Scott et al (1995), and representative sections were cut for immunohistochemical (MC) studies. IHC stains were scored using a previously described semiquantitative scoring system (Allred et al, 1993). Size was taken from the gross measurement if the lesion was palpable or recorded as the largest dimension, as measured on the histological slide, for nonpalpable cases. Of the 70 DCIS cases, 17 (24.3%) were HG, 23 (32.9%) were IG, 21 (30%) were LG, seven (10%) were pure micropapillary cases, and two (2.9%) were pure apocrine DCIS. The mean size of the DCIS for each subcategory was statistically significantly different (P = .008). In particular, the micropapillary DCIS cases were largest (mean size, 17 mm). The mean immunohistochemical scores for c-erb B2 for each category were also statistically different (P = .007), whereas the mean scores for p53 and ki67 for each category trended toward significance (P = .073, P = .062, respectively). There were no significant differences between bcl-2 mean scores and each subcategory. Size of DCIS and c-erb B2 positivity are known to be associated with more aggressive clinical behavior and more advanced histologic features, respectively. Because this combined histological cytological classification system is predictive of size and c-erb B2 positivity, our results support the clinical relevance of this classification system. Copyright (C) 1997 by W.B. Saunders Company.