Balaton André J, Guinebretière Jean-Marc, Penault-Llorca Frédérique
Centre de pathologie, 20 avenue de la Gare, 91570 Bièvres.
Ann Pathol. 2003 Dec;23(6):570-81.
Routine H&E sections are sufficient for diagnosis of the vast majority of breast lesions. Development of mammography mass screening and widespread use of preoperative needle biopsy diagnosis have led to diagnostic difficulties for pathologists. The samples are smaller and more and more preinvasive lesions are seen. It is mainly in those situations that immunohistochemistry (IHC) can efficiently back up histopathology. This review details the main applications of diagnostic IHC in breast pathology. The advantages of IHC in various clinical situations are discussed diagnosis of benign breast lesions mimicking malignancy, distinction between simple type ductal hyperplasia and atypical hyperplasia or ductal in situ carcinoma, confirmation of malignancy, distinction between lobular and ductal carcinoma, identification of specific histological subtypes, and, diagnosis of intra and extra mammary metastases.
常规苏木精-伊红(H&E)切片足以诊断绝大多数乳腺病变。乳腺钼靶筛查的发展以及术前针吸活检诊断的广泛应用给病理学家带来了诊断难题。样本越来越小,且越来越多的原位癌前病变被发现。主要在这些情况下,免疫组织化学(IHC)能够有效地辅助组织病理学诊断。本综述详细介绍了诊断性免疫组织化学在乳腺病理学中的主要应用。讨论了免疫组织化学在各种临床情况下的优势,包括鉴别疑似恶性的良性乳腺病变、区分单纯性导管增生与非典型增生或导管原位癌、确诊恶性肿瘤、区分小叶癌和导管癌、识别特定的组织学亚型,以及诊断乳腺内和乳腺外转移。