Department of Diagnostic Pathology, St Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan.
Pathol Int. 2010 Jun;60(6):459-65. doi: 10.1111/j.1440-1827.2010.02544.x.
Endocrine ductal carcinoma in situ (E-DCIS) is an intraductal carcinoma characterized by endocrine features and expression of neuroendocrine markers. E-DCIS and intraductal papilloma (IDP) resemble in their clinical features. However, the former is an intraductal carcinoma, and the latter is an intraductal benign lesion. It is sometimes difficult to distinguish E-DCIS from IDP because both can show near solid intraductal cellular proliferation. Discrimination between lesions is important not only histopathologically, but also clinically. This study aimed to evaluate the applicability of CD56 and CD57 for the discrimination between E-DCIS and IDP. Specimens were obtained from 17 E-DCIS patients as the subject group, and 27 IDP patients as the control group, diagnosed in St Marianna University Hospital. E-DCIS was diagnosed using Chromogranin A, Synaptophysin, and Grimelius stainings by the premise of histopathological features. These specimens were subjected to CD56, CD57 immunostainings. Staining results were compared between E-DCIS and IDP. In our study, CD56 revealed significant differences for distinguishing E-DCIS from IDP as determined by Fisher's test (cutoff: not less than 33-67%< immunopositivity, P < 0.05). We found that not only E-DCIS but also IDP revealed immunopositivity for CD56. However, it is considered that E-DCIS diagnosis is possible by diffuse immunopositivity of CD56 after having been based on histopathology.
内分泌型导管原位癌(E-DCIS)是一种具有内分泌特征和神经内分泌标志物表达的导管内癌。E-DCIS 和导管内乳头状瘤(IDP)在临床特征上相似。然而,前者是一种导管内癌,后者是一种导管内良性病变。有时很难将 E-DCIS 与 IDP 区分开来,因为两者都可以显示出类似实性的导管内细胞增殖。病变的鉴别不仅在组织病理学上很重要,而且在临床上也很重要。本研究旨在评估 CD56 和 CD57 在鉴别 E-DCIS 和 IDP 中的适用性。标本取自 17 例 E-DCIS 患者作为研究组,27 例 IDP 患者作为对照组,均在圣玛丽安娜大学医院诊断。E-DCIS 的诊断依据是组织病理学特征的嗜铬粒蛋白 A、突触素和格里姆利染色。对这些标本进行 CD56、CD57 免疫染色。比较 E-DCIS 和 IDP 之间的染色结果。在我们的研究中,Fisher 检验显示 CD56 在鉴别 E-DCIS 和 IDP 方面有显著差异(截断值:不少于 33-67%<免疫阳性率,P<0.05)。我们发现不仅 E-DCIS 而且 IDP 对 CD56 呈免疫阳性。然而,据认为,在基于组织病理学的基础上,CD56 的弥漫性免疫阳性可以进行 E-DCIS 诊断。