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乳腺导管内增生性病变和乳腺癌中CCN5蛋白的表达及其意义
作者:周国凤1  阮寒光2  桂星星1  瞿伟1  张秀娟3 
单位:1. 南昌市第三医院 病理科, 江西 南昌 330009;
2. 南昌市第三医院 肿瘤科, 江西 南昌 330009;
3. 吉安市第三人民医院 超声科, 江西 吉安 343000
关键词:导管内增生性病变 乳腺癌 CCN5蛋白表达 
分类号:R737.9
出版年·卷·期(页码):2021·49·第五期(489-494)
摘要:

目的:探讨CCN5蛋白在乳腺导管内增生性病变和乳腺癌中的表达情况及其意义。方法:应用免疫组化SP法分别检测20例乳腺正常组织(NBT),110例乳腺增生性病变包括20例普通型导管增生(UDH)、30例不典型导管增生(ADH)、60例导管原位癌(DCIS),以及90例浸润性病变(IL)包括60例浸润性导管癌(IDC)、30例淋巴结转移(LNM)组织中CCN5的表达,并分析表达阳性率与乳腺癌临床病理特征的关系。结果:CCN5蛋白在NBT、UDH、ADH、DCIS、IDC、LNM组织中表达阳性率依次为10.00%(2/20)、15.00%(3/20)、73.33%(22/30)、71.67%(43/60)、35.00%(21/60)、16.67%(5/30),差异有统计学意义(χ2=56.785,P<0.001);CCN5蛋白在NBT、乳腺导管内增生性病变、IL组织中表达阳性率依次为10.00%(2/20)、61.82%(68/110)、28.89%(26/90),差异有统计学意义(χ2=31.944,P<0.001);是否雌激素受体及孕激素受体阳性、不同病理组织分级及肿瘤直径、有无脉管癌栓及淋巴结转移的IDC组织中,CCN5蛋白表达阳性率差异有统计学意义(P<0.05);而不同年龄及部位者CCN5蛋白表达差异无统计学意义(P>0.05)。结论:随着乳腺导管上皮从导管内增生性病变到LNM病变的发展,CCN5蛋白表达水平呈逐渐减低趋势,提示CCN5蛋白表达与导管内增生性病变及乳腺癌发生、临床进展相关,这可为乳腺癌及癌前病变的诊断、临床治疗及预后评估提供理论基础。

Objective: To investigate the expression and clinical significance of CCN5 protein in breast intraductal hyperplastic lesions and breast cancer. Methods: CCN5 was expressed in 20 cases of normal breast tissue(NBT),110 cases of intraductal hyperplasia of breast including 20 cases of usual ductal hyperplasia(UDH), 30 cases of atypical ductal hyperplasia(ADH), 60 cases of ductal carcinoma in situ(DCIS), and 90 cases of invasive lesions(IL) including 60 cases of invasive ductal carcinoma(IDC) and 30 cases of lymph node metastasis(LNM) by immunohistochemical SP method. The relationship between breast cancer and clinicopathological parameters was analyzed.Results: Expression rates of CCN5 protein were 10.00%(2/20),15.00%(3/20), 73.33%(22/30), 71.67%(43/60), 35.00%(21/60) and 16.67%(5/30) in NBT,UDH, ADH, DCIS, IDC, and LNM respectively, and the differences among them were statistically significant(χ2=56.785, P<0.001). Expression rates of CCN5 protein in NBT, intraductal hyperplastic lesions,and IL were 10.00%(2/20), 61.82%(8/110) and 28.89%(6/90) respectively, and the differences were statistically significant(χ2=31.944, P<0.001). Expression rates of CCN5 protein were significantly different(P<0.05) in IDC with different ER, PR, pathological grade, tumor diameter, vascular tumor thrombus and lymph node metastasis, but were not significantly affected by age or location(P>0.05).Conclusion: With the development of breast ductal epithelial from UDH to LNM, the expression rate of the CCN5 protein gradually decreases, suggesting that the CCN5 expression is related to the occurrence and clinical progress of intraductal proliferative lesions and breast cancer. This result may provide a new theoretical basis for diagnosis, clinical treatment and prognosic evaluation of breast cancer and precancerous lesions.

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