Nizze H, al-Thobhani A K, Terpe H
Institut für Pathologie, Universität Rostock.
Zentralbl Chir. 1998;123 Suppl 5:14-8.
In addition to classical morphological prognosis factors of breast carcinoma (pTNM stage, tumor grading, histological typing), many other immunohistochemical markers of different prognostic value exist.--The comparative estrogen (ER) and progesterone receptor (PR) analysis of normal and pathological breast tissue showed a gradually inverse biological correlation between the decrease of ER+PR+ and the increase of ER-PR-frequency from benign breast changes to noninvasive and invasive breast carcinomas. In benign breast epithelium, ER+PR+ and ER-PR+ might be regarded as low-risk phenotype, whereas ER+PR- and ER-PR- could be estimated as high-risk phenotype in view of a later dedifferentiation and possible malignization.--During carcinogenesis, the initial loss of epithelial growth factor receptor (EGF-R) as well as its later neoexpression could be regarded as a progression maker.--The proliferation rate (Ki67) in breast cancer significantly correlates with increasing grading and apoptosis rate, whereas the expression of bcl-2-protooncogene is inverse to increasing grading. As for the prognostic value of the single factors, it is supposed that they mostly might represent "one piece of a larger puzzle" [13].
除了乳腺癌的经典形态学预后因素(pTNM分期、肿瘤分级、组织学类型)外,还存在许多其他具有不同预后价值的免疫组化标志物。——对正常和病理乳腺组织进行的雌激素(ER)和孕激素受体(PR)比较分析显示,从良性乳腺病变到非浸润性和浸润性乳腺癌,ER+PR+的减少与ER-PR-频率的增加之间存在逐渐相反的生物学相关性。在良性乳腺上皮中,ER+PR+和ER-PR+可被视为低风险表型,而鉴于后期的去分化和可能的恶性化,ER+PR-和ER-PR-可被估计为高风险表型。——在致癌过程中,上皮生长因子受体(EGF-R)的最初缺失及其后期的新表达可被视为进展标志物。——乳腺癌中的增殖率(Ki67)与分级增加和凋亡率显著相关,而bcl-2原癌基因的表达与分级增加呈相反关系。至于单一因素的预后价值,推测它们大多可能代表“更大拼图中的一块”[13]。