细针吸取细胞块免疫细胞化学检测在乳腺癌转移灶的应用研究

目的用乳腺癌转移灶细针吸取细胞学细胞蜡块,检测雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)及Ki-67蛋白表达,探讨与原发灶肿瘤细胞表达的差异。方法收集中国医学科学院肿瘤医院108例乳腺癌患者转移灶细胞蜡块标本,全自动免疫组化仪检测ER、PR、HER-2及Ki-67的蛋白表达。结果ER、PR、Ki-67在乳腺癌原发灶表达阳性率分别为53.7%、53.7%、93.5%,明显高于转移灶的阳性率38.0%、36.1%、69.4%,差异显著(P<0.05)。HER-2阳性率在原发灶与转移灶均为25.0%,无统计学意义(P>0.05)。ER、PR、HER-2及Ki-67在原发灶和转移灶总的变异率分别为15.7%、21.3%、9.3%、27.8%。结论乳腺癌转移灶与原发灶分子分型表达的不一致率与文献相符,鉴于细针吸取细胞学的取材优势,可以将此方法应用于临床诊断。

Application of immunocytochemistry of fine needle aspiration cell block in breast cancer metastases

Objective To detect the exprssion of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor 2(HER2)and Ki-67 by using fine needle aspiration cytology and cell block technique in breast cancer patients with metastasis,and to explore the difference in the expression of tumor cells between the metastatic and primary tumors.Methods The cell block specimens of 108 patients with breast cancer metastases were collected from the Cancer Hospital of the Chinese Academy of Medical Sciences.The protein expression of ER,PR,HER-2 and Ki-67 was detected by an automatic immunohistochemistry.Results The positive rates of ER,PR and Ki-67 in primary breast cancer were 53.7%,53.7%and 93.5%respectively,which were significantly higher than those in metastatic breast cancer38.0%,36.1%and 69.4%(P<0.05).The positive rate of HER-2 was 25.0%in both primary and metastatic lesions(P>0.05).The total variation rates of ER,PR,HER-2 and Ki-67 in primary and metastatic breast cancer were 15.7%,21.3%,9.3%and 27.8%,respectively.Conclusion There are differences in the expression of molecular typing indexes between primary and metastatic breast cancer specimen.Due to the advantages of fine needle aspiration cytology,this method can provide molecular phenotype conveniencely and rapidly for patients,which serves clinical treatment.