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背景与目的粉刺型坏死是导管原位癌预后不良的因素之一,肿瘤细胞侵袭和转移是预后不良的主要原因。本研究拟分析乳腺导管原位中粉刺型坏死与侵袭转移指标间的关系,探讨前者是否与导管原位癌侵袭转移有关。方法按照WHO标准将导管原位癌分成粉刺型和非粉刺型两组,对两组间ER、PR、HER-2、Cathepsin-D、P53蛋白的表达以及癌细胞微浸润、淋巴结受累等指标进行卡方检验。结果在粉刺型和非粉刺型导管原位癌中,ER表达分别为45.3%和63.0%,(P=0.002);PR表达分别为43.6%和55.6%,(P=0.04);HER2(-)、HER2(+)、HER2(++)、HER2(+++)表达分别为15.6%、42.2%、27.9%和28.1%,33.5%、19.3%、19.0%和10.4%(P=0.001);Cathepsin-D表达分别为73.2%和57.8%(P=0.005);P53表达分别为50.8%和43.7%(P=0.254);癌细胞微浸润率分别为46.9%和31.2%(P=0.008);淋巴结受累率分别为10.6%和3.7%(P=0.03)。结论粉刺型坏死与多种侵袭转移因素相关,提示粉刺型导管原位癌相对容易发生侵袭转移。
BACKGROUND & OBJECTIVE Acne-like necrosis is one of the factors leading to the poor prognosis of ductal carcinoma in situ. Invasion and metastasis of tumor cells are the main causes of poor prognosis. This study intends to analyze the relationship between the invasive ductal metastasis and the index of invasive ductal metastasis in ductal carcinoma in situ to discuss whether the former is related to the invasion and metastasis of ductal carcinoma in situ. Methods According to WHO criteria, ductal carcinoma in situ was divided into acne and non-acne groups. The expression of ER, PR, HER-2, Cathepsin-D and P53 protein, microinvasion and lymph node involvement Chi-square test. Results The expression of ER was 45.3% and 63.0% respectively in acne and non-acne ductal carcinoma (P = 0.002). The expression of PR was 43.6% and 55.6% respectively (P = 0.04) , HER2 (+), HER2 (+++) were 15.6%, 42.2%, 27.9% and 28.1%, 33.5%, 19.3%, 19.0% and 10.4% The expression of Cathepsin-D was 73.2% and 57.8% respectively (P = 0.005). The P53 expression was 50.8% and 43.7% (P = 0.254), respectively. The rates of microinvasion were 46.9% and 31.2% (P = 0.008) The rates of lymph node involvement were 10.6% and 3.7%, respectively (P = 0.03). Conclusions Acne necrosis is associated with a variety of invasion and metastasis, suggesting that acne-prone ductal carcinoma in situ is relatively prone to invasion and metastasis.