Selim A G, Ryan A, El-Ayat G A, Wells C A
Department of Histopathology, St Bartholomew's and the Royal London School of Medicine and Dentistry, St Bartholomew's Hospital, London, United Kingdom.
Cancer Detect Prev. 2001;25(3):262-7.
Recently, there have been studies suggesting that apocrine adenosis of the breast is a putative precancerous lesion, despite the generally held view that apocrine adenosis is benign. Because apocrine adenosis is almost always present as a small area or areas, it cannot be easily studied by conventional methods. In this study, areas of apocrine adenosis were microdissected from archival paraffin-embedded tissue to examine loss of heterozygosity and allelic imbalance compared with normal breast tissue epithelium from the same patients. Seventeen cases of apocrine adenosis, four associated with carcinoma, were analyzed using polymorphic microsatellite markers and polymerase chain reaction for loss of heterozygosity/allelic imbalance at eight loci that were reported to show allele loss or imbalance in invasive and in situ breast cancer. Loss of heterozygosity/allelic imbalance was detected in six of 17 cases of apocrine adenosis; three of 12 (25%) informative cases at 1p (MYCL1), two of seven (28.6%) at 11q (INT2), one of three (33.3%) at 13q (D13S267), two of 12 (16.7%) at 16q (D16S539), and two of 10 (20%) at 17q (D17S250). Neither loss of heterozygosity nor allelic imbalance has been identified at 1p (D1S252), 17p (TP53), or 17p (D17S513). In two of the four cases associated with carcinoma, loss of heterozygosity/allelic imbalance was seen in the same allele as in the synchronous carcinoma. These results suggest that molecular alterations, such as loss of heterozygosity and allelic imbalance, identified in apocrine adenosis may constitute an early event in the pathogenesis of breast cancer; reinforcing the possibility of apocrine adenosis being a putative precancerous lesion.
最近,有研究表明,尽管人们普遍认为乳腺大汗腺腺病是良性的,但它可能是一种癌前病变。由于大汗腺腺病几乎总是表现为一个或多个小区域,因此难以用传统方法进行研究。在本研究中,从存档石蜡包埋组织中显微切割出大汗腺腺病区域,以检测与同一患者正常乳腺组织上皮相比的杂合性缺失和等位基因失衡情况。使用多态性微卫星标记和聚合酶链反应,对17例大汗腺腺病病例(其中4例与癌相关)进行分析,检测8个位点的杂合性缺失/等位基因失衡情况,这些位点据报道在浸润性和原位乳腺癌中显示等位基因缺失或失衡。在17例大汗腺腺病病例中,有6例检测到杂合性缺失/等位基因失衡;在1p(MYCL1)的12例信息性病例中有3例(25%),在11q(INT2)的7例中有2例(28.6%),在13q(D13S267)的3例中有1例(33.3%),在16q(D16S539)的12例中有2例(16.7%),在17q(D17S250)的10例中有2例(20%)。在1p(D1S252)、17p(TP53)或17p(D17S513)未发现杂合性缺失或等位基因失衡。在4例与癌相关的病例中,有2例的杂合性缺失/等位基因失衡与同期癌的等位基因相同。这些结果表明,在大汗腺腺病中发现的分子改变,如杂合性缺失和等位基因失衡,可能是乳腺癌发病机制中的早期事件;这进一步支持了大汗腺腺病是一种癌前病变的可能性。