Gel'shteĭn V I, Chipysheva T A, Ermilova V D, Liubimov A V
Arkh Patol. 1990;52(9):12-8.
Monoclonal antibodies to keratins No. 8 and 17 specific for lining epithelium and myoepithelium of the mammary gland, respectively, as well as to basement membrane laminin, entactin, collagen type IV and heparan sulfate proteoglycan were used to the immunohistochemical analysis of 77 benign and malignant human breast lesions and that of 38 cases in which an intraoperative biopsy diagnosis was difficult. Morphologically similar benign and malignant proliferations were distinguished by keratin expression. In benign lesions both keratins were present, while in malignant ones only keratin No. 8 was expressed. Basement membranes associated with a myoepithelial layer were intact in benign lesions and in situ structures, but they were absent around the vast majority of invasive tumor foci. Basement membrane loss was important in differential diagnosis of benign sclerosing adenosis and cystadenopapilloma from invasive tubular and papillary carcinoma, respectively. Diagnosis of microinvasion in ductal and lobular carcinoma was much easier when combination of antibodies to keratins and basement membrane proteins was used.
分别针对乳腺内衬上皮和肌上皮的角蛋白8和17的单克隆抗体,以及针对基底膜层粘连蛋白、巢蛋白、IV型胶原和硫酸乙酰肝素蛋白聚糖的单克隆抗体,用于对77例人类乳腺良恶性病变以及38例术中活检诊断困难的病例进行免疫组织化学分析。通过角蛋白表达区分形态学上相似的良性和恶性增殖。在良性病变中两种角蛋白均存在,而在恶性病变中仅表达角蛋白8。与肌上皮层相关的基底膜在良性病变和原位结构中完整,但在绝大多数浸润性肿瘤灶周围缺失。基底膜缺失分别在良性硬化性腺病和囊腺乳头状瘤与浸润性管状癌和乳头状癌的鉴别诊断中具有重要意义。当联合使用角蛋白和基底膜蛋白抗体时,导管癌和小叶癌微浸润的诊断要容易得多。