Acs G, Lawton T J, Rebbeck T R, LiVolsi V A, Zhang P J
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, 6 Founders Pavilion, 3400 Spruce St, Philadelphia, PA 19104, USA.
Am J Clin Pathol. 2001 Jan;115(1):85-98. doi: 10.1309/FDHX-L92R-BATQ-2GE0.
We studied the pattern of E-cadherin expression in 183 invasive carcinomas (100 ductal, 42 lobular, 41 with mixed ductal and lobular features) and 198 in situ carcinomas (131 ductal, 53 lobular, 14 in situ with ductal and lobular features) by immunohistochemistry. We found a highly significant correlation of E-cadherin membrane expression with the histologic phenotype of the tumors. While moderate to strong membrane expression of E-cadherin was seen in all invasive and in situ ductal carcinomas, 41 of 42 invasive and 50 of 53 in situ lobular carcinomas showed complete loss of expression. All in situ carcinomas diagnosed histologically as showing mixed ductal and lobular features demonstrated complete loss of staining. Invasive carcinomas with ductal and lobular features showed 3 staining patterns: (1) complete or almost complete lack of membrane staining similar to that seen in lobular carcinomas, (2) uniform membrane expression throughout the tumor similar to ductal carcinomas, and (3) focal loss of E-cadherin staining, which correlated well with the histologic impression of focal lobular features. In tumors with histologically equivocal features, immunohistochemical detection of E-cadherin expression can be a useful diagnostic tool for the differentiation of ductal and lobular carcinomas of the breast.
我们通过免疫组织化学研究了183例浸润性癌（100例导管癌、42例小叶癌、41例具有导管和小叶混合特征）和198例原位癌（131例导管原位癌、53例小叶原位癌、14例具有导管和小叶特征的原位癌）中E-钙黏蛋白的表达模式。我们发现E-钙黏蛋白膜表达与肿瘤的组织学表型高度相关。虽然在所有浸润性和原位导管癌中均可见E-钙黏蛋白中度至强膜表达，但42例浸润性小叶癌中有41例以及53例原位小叶癌中有50例显示表达完全缺失。所有组织学诊断为具有导管和小叶混合特征的原位癌均显示染色完全缺失。具有导管和小叶特征的浸润性癌表现出3种染色模式：（1）完全或几乎完全缺乏膜染色，类似于小叶癌；（2）整个肿瘤中膜表达均匀，类似于导管癌；（3）E-钙黏蛋白染色局灶性缺失，这与局灶性小叶特征的组织学表现密切相关。在组织学特征不明确的肿瘤中，E-钙黏蛋白表达的免疫组化检测可作为鉴别乳腺导管癌和小叶癌的有用诊断工具。
