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肥大细胞浸润密度与浸润性乳腺癌分子分型关系的初步研究
作者:黄韬  伊丹丹  桑剑锋 
单位:南京医科大学鼓楼临床医学院 甲乳外科, 江苏 南京 210008
关键词:浸润性乳腺癌 肥大细胞 辅助化疗 
分类号:R655.8
出版年·卷·期(页码):2016·35·第六期(956-960)
摘要:

目的:探讨浸润性乳腺癌(非特殊类型)各个预后影响因素及新辅助化疗对乳腺癌组织中肥大细胞密度(MCD)的影响,进一步分析肥大细胞浸润与乳腺癌新辅助化疗的相关性及临床意义。方法:(1)采用甲苯胺蓝特殊染色法检测195例浸润性乳腺癌(非特殊类型)癌巢内肥大细胞浸润情况,由两名病理专科医师阅片并计数MCD,应用统计分析软件SPSS 22.0分析MCD与乳腺癌临床病理特征的关系。(2)58例浸润性乳腺癌(非特殊类型)患者接受新辅助化疗,同样的方法分别计数新辅助化疗前后癌巢内MCD,并应用统计分析软件SPSS 22.0进行分析对比。结果:(1)在195例浸润性乳腺癌(非特殊类型)中,ER阳性癌巢中MCD较ER阴性癌巢中高,PR阳性癌巢中MCD较PR阴性癌巢中高,差异均有统计学意义(P<0.05);浸润性小叶癌癌巢中MCD高于浸润性导管癌,但差异无统计学意义(P>0.05)。MCD与年龄、肿块大小、区域淋巴结状况、Her-2及Ki67等因素无关(P>0.05)。Luminal各型之间相互比较,Luminal A、Luminal B型者癌巢中MCD较Her-2过表达型及三阴型者高,但是仅Luminal B型者与三阴型者之间差异有统计学意义(P<0.05),其余各型之间差异无统计学意义(P>0.05)。(2)新辅助化疗后患者癌巢内MCD明显高于新辅助化疗前,差异有统计学意义(P<0.05)。结论:激素受体阳性乳腺癌癌巢内肥大细胞浸润程度较激素受体阴性者高,提示肥大细胞可能通过ER、PR影响乳腺癌预后,乳腺癌患者化疗后癌巢中肥大细胞增多,从而可能发挥抗肿瘤作用。

Objective: To investigate the mast cell density(MCD) in carcinoma nest of patients with invasive breast cancer(non-specific types), and analyze the correlation between MCD and clinical prognosis factors of breast cancer. Methods: (1) The MCD was calculated in 195 cases of invasive breast cancer(non-specific types) by two pathologists. Toluidine blue dyeing was used to examine the infiltration of mast cell. SPSS 22.0 statistic software was applied to analyze the data. (2) 58 cases of invasive breast cancer(non-specific types) accepted neo-adjuvant chemotherapy before surgery. We used the same procedure to calculate the MCD in cancer nest before and after neo-adjuvant chemotherapy. SPSS 22.0 statistic software was applied to analyze the data. Results: (1) The MCD were higher in invasive breast cancer nest with ER+ and PR+ than those with ER- and PR- respectively, the difference was significant(P<0.05). MCD were higher in invasive lobular carcinoma than in invasive ductal carcinoma, but the difference was not significant(P>0.05). The MCD were higher in Luminal A type and Luminal B type breast cancer nest than those in Her-2 overexpression type and triple-negative type, but only the difference between Luminal B type and triple-negative type was significant(P<0.05), there was no differences between any other Luminal types(P>0.05). There were not enough evidences to prove that MCD was related to age, diameter of the mass, histological type, regional lymph nodes situation, Her-2 and Ki67. (2) The MCD was lower in breast cancer nest before neo-adjuvant chemotherapy than that after neo-adjuvant chemotherapy. The difference was significant(P<0.05). Conclusion: The MCDs in hormone receptors positive breast cancers' nest are higher than those in negative, which indicates that mast cell may have positive effect on breast cancer prognosis by ER and PR. MCD increases in cancer nest after neo-adjuvant chemotherapy, which may play a part in anti-cancer system.

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