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目的：探讨各种乳腺癌前病变与乳腺癌发生的关系。方法：应用全乳腺大切片技术结合ＣＥＡ、ｃ－ｅｒｂＢ－２癌基因产物免疫组化检测及流式细胞术（ＦＣＭ）测定ＤＮＡ含量、Ｓ期细胞比率（ＳＰＦ）和细胞增殖指数（ＰＩ），对３９３例乳腺癌标本进行癌旁和癌前病变与乳腺癌相关性的多指标综合研究。结果：乳腺癌最多见的癌旁病变是导管上皮增生（５５．２％），其次为囊性增生病（５３．４％）和乳头状瘤病（２２．２％）。其中与乳腺癌关系较密切的癌前病变是导管上皮增生和乳头状瘤病。通过多指标检测证实，导管上皮重度不典型增生和重度乳头状瘤病是与乳腺癌最密切相关的癌前病变，其中２９．３％有１～２项检测指标呈高水平表达的病变，应视为可疑早期癌，１２．２％有２项以上指标呈高水平表达的病变应按早期乳腺癌对待。结论：对癌前病变特别是导管上皮重度不典型增生和重度乳头状瘤病进行ＣＥＡ、ｃ－ｅｒｂＢ－２癌基因及ＦＣＭ分析等多项指标检测，有利于发现早期乳腺癌，并将为乳腺癌的病理学早期诊断提供新的重要依据。
Objective: To explore the relationship between various breast cancer precancerous lesions and the occurrence of breast cancer. METHODS: Immunohistochemical detection of CEA and c-erbB-2 oncogene products and flow cytometry (FCM) were used to measure DNA content, S phase cell ratio (SPF), and cell proliferation index (PI). A multi-index comprehensive study of the correlation between paracancerous and precancerous lesions and breast cancer was performed on 393 breast cancer specimens. RESULTS: The most common paraneoplastic lesions in breast cancer were ductal hyperplasia (55.2%), followed by cystic hyperplasia (53.4%) and papillomatosis (22.2%). The precancerous lesions that are more closely related to breast cancer are ductal epithelial hyperplasia and papillomatosis. Through multi-indicator testing, it was confirmed that severe atypical hyperplasia of ductal epithelium and severe papillomatosis were the most precancerous lesions associated with breast cancer, of which 29.3% had 1 or 2 lesions with high expression levels. Considered as suspicious early cancer, 12.2% of the lesions with more than 2 indicators of high levels of expression should be treated as early breast cancer. CONCLUSIONS: Detection of CEA, c-erbB-2 oncogenes, and FCM analysis of precancerous lesions, particularly severe atypical hyperplasia of the ductal epithelium and severe papillomatosis, is beneficial to the detection of early stage breast cancer and will be a breast The early diagnosis of cancer pathology provides a new important basis.