Carcinomas in situ of the breast with indeterminate features - Role of E-cadherin staining in categorization
Carcinomas in situ of the breast with indeterminate features - Role of E-cadherin staining in categorization
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DOI：
10.1097/00000478-200102000-00011
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发表时间：
2001-02-01
影响因子：
5.6
通讯作者：
Schnitt, SJ
中科院分区：
文献类型：
--
作者：
Jacobs, TW;Pliss, N;Schnitt, SJ
大多数乳腺原位癌（CIS）很容易分为导管癌（DCIS）或小叶癌（LCIS）。然而，一些CIS具有不确定的组织学特征（CIS-IF）。以前的研究表明，E-钙粘蛋白的表达在小叶癌中丢失，但在导管癌中没有丢失。因此，评价的例子，CIS-IF的E-钙粘蛋白表达免疫组织化学可能有助于确定其性质。为了解决这个问题，我们研究了89例乳腺CIS（28例LCIS，33例DCIS，28例CIS-IF）的组织学特征和E-cadherin的表达。CIS-IF病例根据组织学分为三组：第1组病例具有LCIS的所有典型细胞学和结构特征，但显示粉刺型坏死区域（n = 6），第2组病例为CIS病变，其特征在于小而均匀的肿瘤细胞以实性模式生长，具有局灶性微泡样结构，但具有细胞病变，第3组表现为明显的细胞多形性和核分裂，但具有LCIS的特征性生长异常（n = 5）。E-钙粘蛋白染色评分为阴性、阳性或混合（阴性和阳性肿瘤细胞的混合）。免疫组化结果显示，28例LCIS均为E-cadherin阴性，33例DCIS均为E-cadherin阳性。所有来自CIS-IF组1和组3的病例均为E-钙粘蛋白阴性，表明LCIS比DCIS更接近亲缘关系。相反，CIS-IF组2例患者的E-钙粘蛋白染色呈异质性。6例（35.3%）E-cadherin阴性（更类似于LCIS），5例（29.4%）E-cadherin阳性（类似于DCIS），6例（35.3%）E-cadherin阳性和E-cadherin阴性：肿瘤细胞，表明DCIS/LCIS混合表型。我们的研究结果表明，E-钙粘蛋白免疫染色是有价值的，有助于表征乳腺癌原位与不确定的功能。然而，这些观察结果的验证将需要临床结局研究。
Most breast carcinomas in situ (CIS) are easily categorized as ductal (DCIS) or lobular (LCIS). However, some CIS have indeterminate histologic features (CIS-IF). Prior studies have shown that E-cadherin protein expression is lost in lobular but not ductal carcinomas. Therefore, evaluation of examples of CIS-IF for E-cadherin expression by immunohistochemistry might be useful in helping to define their nature. To address this, we studied histologic features and E-cadherin expression by immunohistochemistry in 89 cases of breast CIS (28 LCIS, 33 DCIS, 28 CIS-IF). CIS-IF cases were divided into three groups based on histology: Group 1 cases had all the cytologic and architectural features typical of LCIS but showed areas of comedo-type necrosis (n = 6), Group 2 cases were CIS lesions characterized by small, uniform neoplastic cells either growing in a solid pattern with focal microacinar-like structures but with cellular dyshesion, or growing in a cohesive mosaic pattern but with occasional intracytoplasmic vacuoles (n = 17), Group 3 cases showed marked cellular pleomorphism and nuclear atypia but had the dyshesive growth pattern characteristic of LCIS (n = 5). E-cadherin staining was scored as negative, positive, or mixed (mixture of negative and positive tumor cells). All 28 cases of LCIS were E-cadherin negative, and all 33 DCIS cases were E-cadherin positive by immunohistochemistry. All cases from CIS-IF group 1 and group 3 were negative for E-cadherin, suggesting a closer kinship to LCIS than to DCIS. In contrast, CIS-IF group 2 cases were heterogeneous with respect to E-cadherin staining. Six (35.3%) cases were E-cadherin negative (more akin to LCIS), 5 (29.4%) cases were E-cadherin positive (akin to DCIS), and 6 (35.3%) cases had both E-cadherin-positive and E-cadherin-negative: tumor cells, suggesting a mixed DCIS/LCIS phenotype. Our findings suggest that E-cadherin immunostaining is of value in helping to characterize breast carcinomas in situ with indeterminate features. However, validation of these observations will require clinical outcome studies.