Kajiwara M, Toyoshima S, Yao T, Tanaka M, Tsuneyoshi M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
J Surg Oncol. 1999 Apr;70(4):209-16. doi: 10.1002/(sici)1096-9098(199904)70:4<209::aid-jso2>3.0.co;2-6.
Medullary carcinoma of the breast has generally been considered to result in better prognosis than ordinary invasive ductal carcinoma, which would seem to be discrepant when one considers its anaplastic histology and high mitotic rate. We attempted to elucidate the prognostic implications of apoptosis and cell proliferation in medullary carcinoma of the breast.
Formalin-fixed, paraffin-embedded specimens of 50 cases of typical medullary carcinoma (MC) of the breast and those of 50 control cases of non-medullary invasive ductal carcinoma (N-MC), which were matched to the MC cases in both age and TNM classification, were investigated utilizing the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) method and immunohistochemistry for p53, bcl-2, and Ki-67.
Mean values of the apoptotic index (AI), the proliferative index (PI), and the ratio of AI to PI (AI/PI) were significantly higher in MC than in N-MC (P < 0.0001). MC exhibited significantly lower positivity for bcl-2 than N-MC (P = 0.00003), while there was no significant difference in p53 positivity between MC and N-MC.
A high frequency of apoptosis may be related to a favorable prognosis in MC, even though it demonstrates a high proliferative activity, exhibiting a rapid cell turnover.
乳腺髓样癌通常被认为比普通浸润性导管癌预后更好，然而考虑到其间变的组织学特征和高有丝分裂率，这似乎存在矛盾。我们试图阐明乳腺髓样癌中细胞凋亡和细胞增殖的预后意义。
采用末端脱氧核苷酸转移酶介导的dUTP-生物素缺口末端标记法（TUNEL法）以及p53、bcl-2和Ki-67免疫组化法，对50例乳腺典型髓样癌（MC）的福尔马林固定、石蜡包埋标本以及50例非髓样浸润性导管癌（N-MC）对照标本进行研究，N-MC病例在年龄和TNM分类上与MC病例相匹配。
MC的凋亡指数（AI）、增殖指数（PI）以及AI与PI的比值（AI/PI）平均值显著高于N-MC（P < 0.0001）。MC的bcl-2阳性率显著低于N-MC（P = 0.00003），而MC与N-MC的p53阳性率无显著差异。
尽管MC表现出高增殖活性和快速的细胞更新，但高频率的细胞凋亡可能与MC的良好预后相关。
