CAJ | 학술논문

目的：探讨CK5／6、CK14、雌激素受体（ ER）和孕激素受体（ PR）表达模式在普通型导管上皮增生（UDH）、不典型导管上皮增生（ADH）和低级别导管原位癌（DCIS）辅助病理诊断中的意义。方法2013年1月至2014年2月天津医科大学肿瘤医院病理诊断为乳腺ADH、灶性早期癌变为低级别DCIS的连续病例20例，收集其相关临床病理资料，并进行CK5／6、CK14、ER和PR免疫组化检测。结果 CK5／6、CK14在UDH腺上皮细胞中阳性表达，呈镶嵌状，而在ADH和低级别DCIS的腺上皮细胞中则呈阴性表达。 CK5／6、CK14在UDH、ADH和低级别DCIS的肌上皮细胞均有阳性表达。ER、PR在UDH、ADH和低级别DCIS的腺上皮中均有阳性表达，在ADH和低级别DCIS中表现为弥漫、均匀一致的强阳性，而在UDH中表现为少数细胞异质性阳性。结论在乳腺导管内增生性病变中，联合检测CK5／6、CK14、ER和PR的表达，对UDH、ADH和低级别DCIS的辅助鉴别诊断有着切实可行的意义。
목적：탐토CK5／6、CK14、자격소수체（ ER）화잉격소수체（ PR）표체모식재보통형도관상피증생（UDH）、불전형도관상피증생（ADH）화저급별도관원위암（DCIS）보조병리진단중적의의。방법2013년1월지2014년2월천진의과대학종류의원병리진단위유선ADH、조성조기암변위저급별DCIS적련속병례20례，수집기상관림상병리자료，병진행CK5／6、CK14、ER화PR면역조화검측。결과 CK5／6、CK14재UDH선상피세포중양성표체，정양감상，이재ADH화저급별DCIS적선상피세포중칙정음성표체。 CK5／6、CK14재UDH、ADH화저급별DCIS적기상피세포균유양성표체。ER、PR재UDH、ADH화저급별DCIS적선상피중균유양성표체，재ADH화저급별DCIS중표현위미만、균균일치적강양성，이재UDH중표현위소수세포이질성양성。결론재유선도관내증생성병변중，연합검측CK5／6、CK14、ER화PR적표체，대UDH、ADH화저급별DCIS적보조감별진단유착절실가행적의의。
Objective To investigate the expression of high?molecular?weight keratins CK5/6, CK14, estrogen receptor ( ER) and progesterone receptor ( PR) in differential diagnosis of simple ductal hyperplasia ( UDH) , atypical ductal hyperplasia ( ADH) and low?grade ductal carcinoma in situ ( low?grade DCIS) . Methods The clinicopathological data of twenty cases of atypical ductal epithelial hyperplasia ( ADH) with focal cancerization changed into low?grade DCIS diagnosed at Tianjin Medical University Cancer Institute and Hospital between January 2013 and February 2014 were reviewed and analyzed. The expressions of CK5/6, CK14, ER and PR were detected by immunohistochemistry. Results Positive expressions of CK5/6 and CK14 were seen in UDH showing a mosaic pattern, while negative expression in ADH and low?grade DCIS. In addition, CK5/6 and CK14 were positively expressed in the myoepithelial cells of UDH, ADH and low?grade DCIS. Positive expressions of ER and PR were observed in UDH, ADH and low?grade DCIS. But they presented diffuse and homogeneous strong positive expression in ADH and variable positive expression in UDH. Conclusion In the intraductal proliferative lesions of the breast, the use of combined detection of the expression of CK5/6, CK14, ER and PR is of practical significance in the differential diagnosis of UDH, ADH and low?grade DCIS.