Böcker W, Bier B, Freytag G, Brömmelkamp B, Jarasch E D, Edel G, Dockhorn-Dworniczak B, Schmid K W
Gerhard-Domagk-Institute of Pathology, University of Münster, Federal Republic of Germany.
Virchows Arch A Pathol Anat Histopathol. 1992;421(4):323-30. doi: 10.1007/BF01660979.
A detailed immunohistochemical study has been carried out on 63 breast lesions with epitheliosis, ductal carcinoma in situ and clinging carcinoma (lobular cancerization), using antibodies directed against keratins 5/14 and 14, 15, 16, 18, 19, vimentin, smooth muscle actin, collagen IV and laminin. The results have shown that epitheliosis on the one hand and ductal in situ and clinging carcinoma on the other are immunohistochemically different epithelial lesions. Epitheliosis appears to be epithelial hyperplasia with keratin 5/14 and keratin 14, 15, 16, 18, 19-positive cells. Compared to epitheliotic cells tumor cells of clinging carcinoma, lobular cancerization and ductal carcinoma in situ expressed only luminal keratins 14, 15, 16, 18, 19 in 85% of the cases studied; whereas in 15% there was a basal keratin expression. From our results we conclude that the clinging carcinoma (lobular cancerization) represents the initial morphological step in the development of ductal carcinoma in situ and thus may be interpreted as a minimal ductal neoplasia. With the immunohistochemical demonstration of basal and luminal keratins it may be possible in individual cases to differentiate between benign and malignant in situ lesions of the breast.
利用针对角蛋白5/14、14、15、16、18、19、波形蛋白、平滑肌肌动蛋白、IV型胶原和层粘连蛋白的抗体，对63例伴有上皮组织增生、导管原位癌和贴壁癌（小叶癌化）的乳腺病变进行了详细的免疫组织化学研究。结果表明，一方面上皮组织增生，另一方面导管原位癌和贴壁癌是免疫组织化学上不同的上皮性病变。上皮组织增生表现为角蛋白5/14以及角蛋白14、15、16、18、19阳性细胞的上皮增生。与上皮组织增生细胞相比，贴壁癌、小叶癌化和导管原位癌的肿瘤细胞在85%的研究病例中仅表达腔面角蛋白14、15、16、18、19；而在15%的病例中有基底角蛋白表达。从我们的结果可以得出结论，贴壁癌（小叶癌化）代表导管原位癌发展过程中的初始形态学阶段，因此可被解释为最小的导管肿瘤。通过基底和腔面角蛋白的免疫组织化学显示，在个别病例中有可能区分乳腺原位良性和恶性病变。
