目的:探讨乳腺导管原位癌(ductal carcinoma in situ of the breast，DCIS)、导管原位癌伴微浸润(ductal carcinoma in situ with microinvasion，DCIS-MI)、乳腺导管原位癌伴浸润性导管癌(ductal carcinoma in situ with invasive ductal cancer，DCIS-IDC)与浸润性导管癌(invasive ductal cancer，IDC)的分子分型差异。方法:回顾性分析本院2012年01月至2022年11月经术后病理证实的乳腺癌2 048例患者资料，记录四组患者免疫组化标记物[雌激素受体(estrogen receptor，ER)、孕激素受体(progesterone receptor，PR)、人表皮生长因子受体(human epidermal growth factor receptor-2，Her-2)、肿瘤细胞增殖活性标志物(Ki-67)]、分子分型及核异型性的情况，采用x2检验或Fisher确切概率法比较四组患者免疫组化标记物、分子分型及核异型性差异性。结果:2 048例乳腺癌患者，其中DCIS组为181例，DCIS-MI组为69例，DCIS-IDC组为702例，IDC组为1 096例。免疫组织化学标记物方面:DCIS、DCIS-MI、DCIS-IDC及IDC患者在ER、PR、Her-2、Ki-67中的阳性分布差异均有显著统计学意义(P均＜0。001);ER、PR阳性DCIS-MI组明显低于DCIS组、DCIS-IDC组及IDC组，Her-2阳性DCIS-MI组明显高于DCIS组、DCIS-IDC组及IDC组，Ki-67高表达DCIS组明显低于DCIS-MI组、DCIS-IDC组及IDC组，差异均有显著统计学意义(P均＜0。001)。分子分型方面:DCIS-MI组以Her-2过表达型较常见(55。1％);DCIS-IDC及IDC组以Luminal B型为主，分别为52。7％、56。7％;DCIS组以Her-2过表达型、Luminal A型、Luminal B型平均分布多见，分别为32。6％、32。0％、31。5％，四组数据在分子分型上总体有显著差异，具有统计学意义(P＜0。001)。DCIS、DCIS-MI、DCIS-IDC、IDC组间两两比较，差异均具有统计学意义(P均＜0。05)。核异型性方面:DCIS、DCIS-MI及DCIS-IDC患者在核异型性上差异具有显著统计学意义(P＜0。001)。结论:DCIS-MI免疫组化标记物及分子分型较DCIS、DCIS-IDC、IDC差异明显，是不同于DCIS的乳腺癌组分。
Research molecular typing differences of DCIS,DCIS-Ml,DCIS-IDC and IDC
Objective:To investigate the differences in molecular staging of ductal carcinoma in situ of the breast(DCIS),ductal carcinoma in situ with microinvasion(DCIS-MI),ductal carcinoma in situ with invasive ductal canc-er(DCIS-IDC)and invasive ductal cancer(IDC).Methods:We retrospectively analyzed the data of 2 048 patients with postoperative pathologically confirmed breast cancer in the hospital from January 2012 to November 2022,and re-corded the immunohistochemical markers[estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(Her-2),and markers of proliferative activity of tumor cells(Ki-67)],molecular typing,and nuclear heterozygosity of the patients in four groups,and compared the differences of immunohistochemical mark-ers,molecular typing,and nuclear heterozygosity among patients of the four groups with the use of the x2 test or Fisher's ex-act probability method.Results:2 048 breast cancer patients,of which 181 were in the DCIS group,69 in the DCIS-MI group,702 in the DCIS-IDC group and 1 096 in the IDC group.As for immunohistochemical markers:The differ-ences in the distribution of positivity in ER,PR,Her-2,and Ki-67 among DCIS,DCIS-MI,DCIS-IDC,and IDC patients were all statistically significant(all P＜0.001).The ER-and PR-positive DCIS-MI group were significantly lower than the DCIS group,the DCIS-IDC group,and the IDC group,and the Her-2 positive DCIS-MI group were significantly higher than DCIS group,DCIS-IDC group and IDC group,and Ki-67 high-expression DCIS group were significantly lower than DCIS-MI group,DCIS-IDC group and IDC group,and the differences were all statisti-cally significant(P＜0.001).In terms of molecular typing:Her-2 overexpression type was more common in the DCIS-MI group 55.1％,Luminal B type was predominant in the DCIS-IDC and IDC groups,52.7％and 56.7％,respec-tively,and the average distribution of Her-2 overexpression type,Luminal A type,and Luminal B type were more common in the DCIS group,32.6％,32.0％,and 31.5％,and there was a statistically significant overall difference in molecular typing among the four groups of data(P＜0.001).The difference was statistically significant when compa-ring the DCIS,DCIS-MI,DCIS-IDC,and IDC groups two by two(all P＜0.05).In terms of nuclear heterogeneity:The difference in nuclear heterogeneity among DCIS,DCIS-MI and DCIS-IDC patients was statistically significant(P＜0.001).Conclusion:DCIS-MI immunohistochemical markers and molecular typing differ significantly from DCIS,DCIS-IDC,and IDC,and is a different breast cancer component from DCIS.
ductal carcinoma in situductal carcinoma in situ with microinfiltrationinvasive ductal cancermolecu-lar typing
万方数据
维普
