CAJ | 학술논문

目的：评估不同的免疫表型在导管内增生性病变中的诊断与鉴别诊断中的意义。方法对177例乳头溢液患者在行乳腺导管镜检查后于异常管壁处行活检针定位搔刮，生理盐水冲洗，收集ID P L病例的乳腺导管冲洗液，得到了大量的新鲜细胞标本，采用免疫细胞化学方法分析其免疫表型特点。结果 Her‐2、P53、Ki‐67、CAM5．2在乳腺导管内病变，随着恶性程度的增加，其表达率逐级增加（ P ＜0．05）；CK5／6、P63在乳腺导管内病变各组中的表达亦随恶性程度的增加而降低（ P ＜0．05）。结论乳腺导管冲洗液脱落细胞学诊断乳腺增生性病变较高的敏感性，免疫细胞化学法检测乳腺导管冲洗液脱落细胞的Her‐2、P53、Ki‐67和CAM5．2异常表达和CK5／6和P63的降低和消失发生在乳腺癌发生过程中的早期，联合检测可作为早期诊断癌前病变和估计预后的有效指标。
목적：평고불동적면역표형재도관내증생성병변중적진단여감별진단중적의의。방법대177례유두일액환자재행유선도관경검사후우이상관벽처행활검침정위소괄，생리염수충세，수집ID P L병례적유선도관충세액，득도료대량적신선세포표본，채용면역세포화학방법분석기면역표형특점。결과 Her‐2、P53、Ki‐67、CAM5．2재유선도관내병변，수착악성정도적증가，기표체솔축급증가（ P ＜0．05）；CK5／6、P63재유선도관내병변각조중적표체역수악성정도적증가이강저（ P ＜0．05）。결론유선도관충세액탈락세포학진단유선증생성병변교고적민감성，면역세포화학법검측유선도관충세액탈락세포적Her‐2、P53、Ki‐67화CAM5．2이상표체화CK5／6화P63적강저화소실발생재유선암발생과정중적조기，연합검측가작위조기진단암전병변화고계예후적유효지표。
Objective To assess the immunophenotypic characteristics of intraductal proliferative lesions and their clinical significance .Methods Immunocytochemistry was used to determinate the expression of Her‐2 ,P53 ,Ki‐67 ,CAM5 .2 , CK5/6 and P63 in 177 cases of women with nipple discharge who underwent FDS .Results Immunohistochemieal staining showed that CK5/6 and P63 were obviously expressed in glandular epithelial cells of ordinary‐type ductal hyperplasia , while they were lower or not expressed in atypical ductal hyperplasia ,fiat epithelial atypia and ductal carcinoma in situ . Her‐2 ,P53 ,Ki‐67 and CAM5 .2 were expressed more strongly than CK5/6 and P63 in ductal carcinoma in situ ,but were not expressed in ordinary‐type ductal hyperplasia .Conclusion The abnormal expression of Her‐2 ,P53 ,Ki‐67 ,CAM5 . 2 ,CK5/6 and P63 may be an early event in the progression of breast carcinoma ,and combined detection of them could be used for early diagnosis of breast cancer .