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乳腺结构作为人类乳腺对癌症易感性的一个决定因素。

Mammary gland architecture as a determining factor in the susceptibility of the human breast to cancer.

作者信息

Russo J, Lynch H, Russo I H

机构信息

Breast Cancer Research Laboratory, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19111, USA.

出版信息

Breast J. 2001 Sep-Oct;7(5):278-91. doi: 10.1046/j.1524-4741.2001.21033.x.

Abstract

The developmental pattern of the breast can be assessed by determining the composition of the breast in specific lobular structures, which are designated as lobules type 1 (Lob 1), lobules type 2 (Lob 2), and lobules type 3 (Lob 3), with Lob 1 being the less developed and Lob 3 being the most differentiated or with the highest number of ductules per lobular unit. In the present work, the patient population consisted of three groups of women who underwent surgical procedures: The first group included women who underwent reduction mammoplasty (RM) for cosmetic reasons. The second group included women who underwent prophylactic subcutaneous mastectomy after genetic counseling for either carrying the BRCA-1 gene or belonging to a pedigree with familial breast cancer (FAM), and the third group included women who underwent modified radical mastectomy (MRM) for the diagnosis of invasive carcinoma. The RM group consisted of 33 women, of whom 9 were nulliparous and 24 were parous. The FAM group consisted of 17 women, of whom 8 were nulliparous and 9 were parous. The MRM group consisted of 43 women, of whom 7 were nulliparous and 36 were parous. The analysis of the lobular composition of all of the samples from the RM group, which is considered the control group, revealed that Lob 1 represented 22%, Lob 2 represented 37%, and Lob 3 represented 38%, whereas the tissue examined from the FAM and MRM groups contained a preponderance of Lob 1 at 48% and 74%, respectively, over Lob 3, which was 10% and 3%, respectively. When the results of the analysis of breast tissue were separated according to the pregnancy history of the donor, it was found that in the control group or RM, there was a significant difference in lobular composition. Nulliparous women of the RM group showed a preponderance of Lob 1 (46%) over parous women, which contained only 17%, whereas the percentage of Lob 3 in the nulliparous group was significantly lower (7%) than the parous group (48%). In the breast tissues obtained from FAM and MRM, no significant differences in lobular composition were observed, as all of the samples contained a higher concentration of Lob 1, independent of the pregnancy history. The breast tissue of FAM and MRM of parous women had a developmental pattern that was similar to that of nulliparous women of the same group and that was less developed than the breast of parous women of the control group. An important difference between the Lob 1 of the FAM group versus the control (RM) and the MRM group was that most of these lobules had thin ductules with an increase in hyalinization of the intralobular stroma manifested in the whole-mount preparation as an alteration in the branching pattern. The data suggest that the breast tissue of women with invasive cancer, as well as those from a background of familial breast cancer, have an architectural pattern different from the control or normal tissues and that the BRCA-1 or related genes may have a functional role in the branching pattern of the breast during lobular development, mainly in the epithelial stroma interaction.

摘要

通过确定乳腺特定小叶结构的组成,可以评估乳腺的发育模式,这些小叶结构被指定为1型小叶(Lob 1)、2型小叶(Lob 2)和3型小叶(Lob 3),其中Lob 1发育程度较低,Lob 3分化程度最高或每个小叶单位的小导管数量最多。在本研究中,患者群体由三组接受外科手术的女性组成:第一组包括因美容原因接受乳房缩小成形术(RM)的女性。第二组包括在接受遗传咨询后,因携带BRCA - 1基因或属于家族性乳腺癌(FAM)家系而接受预防性皮下乳房切除术的女性,第三组包括因浸润性癌诊断而接受改良根治性乳房切除术(MRM)的女性。RM组由33名女性组成,其中9名未生育,24名已生育。FAM组由17名女性组成,其中8名未生育,9名已生育。MRM组由43名女性组成,其中7名未生育,36名已生育。对RM组所有样本(被视为对照组)的小叶组成分析显示,Lob 1占22%,Lob 2占37%,Lob 3占38%,而FAM组和MRM组检查的组织中,Lob 1分别占48%和74%,明显多于Lob 3,Lob 3分别仅占10%和3%。当根据供体的妊娠史对乳腺组织分析结果进行分类时,发现对照组或RM组的小叶组成存在显著差异。RM组未生育女性的Lob 1占优势(46%),高于已生育女性,已生育女性中Lob 1仅占17%,而未生育组中Lob 3的百分比(7%)明显低于已生育组(48%)。在从FAM组和MRM组获得的乳腺组织中,未观察到小叶组成的显著差异,因为所有样本中Lob 1的浓度都较高,与妊娠史无关。已生育女性的FAM组和MRM组的乳腺组织发育模式与同组未生育女性相似,且比对照组已生育女性的乳腺发育程度低。FAM组的Lob 1与对照组(RM)和MRM组之间的一个重要差异是,这些小叶中的大多数小导管较细,小叶内间质透明变性增加,在整装标本中表现为分支模式的改变。数据表明,患有浸润性癌的女性以及有家族性乳腺癌背景的女性的乳腺组织具有与对照或正常组织不同的结构模式,并且BRCA - 1或相关基因可能在小叶发育过程中乳腺的分支模式中发挥功能作用,主要是在上皮 - 间质相互作用方面

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