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目的:研究伴癌的乳腺导管内增生性病变与不伴癌的乳腺导管内增生性病变ERα与p53蛋白表达的差异。方法:用免疫组化法研究129例不伴癌的乳腺导管内增生性病变及86例伴癌的乳腺导管内增生性病变中p53及ERα蛋白表达差异。结果:p53蛋白阳性表达于18.2%(14/77)单纯性非典型导管增生(ADH),31.0%(9/29)伴原位癌的ADH(ADH/DCIS),26.7%(8/30)伴浸润性导管癌的ADH(ADH/IDC),三者间表达率差异无统计学意义,P>0.05。ERα在79.3%(23/29)伴原位癌的ADH(ADH/DCIS)中阳性表达,在76.7%(23/30)的伴浸润性导管癌的ADH(ADH/IDC)中阳性表达,均明显低于其在单纯性ADH中的表达(72/77,93.5%),P<0.05。在乳腺导管内增生性病变中,突变型p53蛋白的核聚集与ERα阳性表达的相关系数r=-0.512,P<0.01。结论:初步研究结果提示,虽然不伴癌的ADH与伴癌的ADH有相同的形态学表现,但形成的分子机制可能存在差异。
OBJECTIVE: To study the difference of expression of ERα and p53 protein in breast ductal hyperplasia with or without breast cancer. Methods: Immunohistochemical method was used to study the expression of p53 and ERα protein in 129 cases of ductal hyperplasia without ductal carcinoma and 86 cases of ductal hyperplasia with ductal carcinoma. Results: The positive rate of p53 protein was 18.2% (14/77) in atypical ductal hyperplasia (ADH), ADH (ADH / DCIS) in 31.0% (9/29) with carcinoma in situ, 26.7% There was no significant difference in the expression rates of ADH (ADH / IDC) with invasive ductal carcinoma (P> 0.05). ERα was positively expressed in ADH (ADH / DCIS) with 79.3% (23/29) with carcinoma in situ and was positively expressed in 76.7% (23/30) ADH (ADH / IDC) with invasive ductal carcinoma both Significantly lower than that in simple ADH (72/77, 93.5%), P <0.05. In hyperplastic lesions of mammary duct, the correlation coefficient of nuclear aggregation of mutant p53 protein and ERα positive expression was r = -0.512, P <0.01. CONCLUSIONS: The preliminary results suggest that although the non-cancerous ADH has the same morphologic appearance as the cancerous ADH, the molecular mechanisms involved may differ.