Li Xiaoxian, Schwartz Mary R, Ro Jae, Hamilton Candice R, Ayala Alberto G, Truong Luan D, Zhai Qihui Jim
Department of Pathology and Laboratory Medicine, Emory University Atlanta, GA, USA.
Department of Pathology and Genomic Medicine, Houston Methodist Hospital Houston, TX, USA.
Int J Clin Exp Pathol. 2014 Apr 15;7(5):2551-7. eCollection 2014.
Breast carcinoma in situ (CIS) is classified into ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is treated with surgical excision while LCIS can be clinically followed with or without hormonal treatment. Thus, it is critical to distinguish DCIS from LCIS. Immunohistochemical (IHC) staining for E-cadherin is routinely used to differentiate DCIS from LCIS in diagnostically challenging cases. Circumferential diffuse membranous staining of E-cadherin is the typical pattern in DCIS, whereas LCIS lacks or shows decreased E-cadherin expression. Recent studies have shown that DCIS has membranous staining of P120 catenin and LCIS has diffuse cytoplasmic staining of P120 catenin. We developed a cocktail composed of E-cadherin and P120 catenin primary antibodies so that only one slide is needed for the double immunostains.
Twenty-seven blocks of formalin-fixed paraffin-embedded tissue from 26 cases of DCIS or LCIS were retrieved from the archives of Houston Methodist Hospital. Four consecutive sections from the same blocks were used for H&E and immunohistochemical (IHC) stains. The E-cadherin antibody was a rabbit polyclonal antibody and the P120 catenin antibody was a mouse monoclonal antibody. The E-cadherin primary antibody was detected using a secondary antibody raised against rabbit antibody and was visualized with a brown color. The P120 catenin primary antibody was detected using a secondary antibody raised against mouse antibody and was visualized with a red color.
Using individual antibodies, 15 of 15 DCIS lesions had diffuse circumferential membranous E-cadherin staining (brown stain) or P120 catenin staining (red stain). All 12 LCIS cases showed cytoplasmic P120 red staining or loss of E-cadherin staining when the single P120 catenin or E-cadherin antibody was used. When stained with the antibody cocktail, all 15 DCIS samples showed diffuse red and brown membranous staining without cytoplasmic stain; all 12 LCIS samples showed diffuse cytoplasmic red staining for P120 catenin but no membranous staining for E-cadherin.
乳腺原位癌（CIS）分为导管原位癌（DCIS）和小叶原位癌（LCIS）。DCIS采用手术切除治疗，而LCIS可进行临床随访，可采用或不采用激素治疗。因此，区分DCIS和LCIS至关重要。在诊断有挑战性的病例中，常规使用E-钙黏蛋白的免疫组织化学（IHC）染色来区分DCIS和LCIS。E-钙黏蛋白的环状弥漫性膜染色是DCIS的典型模式，而LCIS缺乏或显示E-钙黏蛋白表达降低。最近的研究表明，DCIS有P120连环蛋白的膜染色，而LCIS有P120连环蛋白的弥漫性细胞质染色。我们开发了一种由E-钙黏蛋白和P120连环蛋白一抗组成的混合抗体，以便双重免疫染色仅需一张切片。
从休斯顿卫理公会医院的档案中检索出26例DCIS或LCIS的27个福尔马林固定石蜡包埋组织块。从同一组织块连续切取四张切片用于苏木精-伊红（H&E）染色和免疫组织化学（IHC）染色。E-钙黏蛋白抗体是兔多克隆抗体，P120连环蛋白抗体是小鼠单克隆抗体。使用针对兔抗体的二抗检测E-钙黏蛋白一抗，并用棕色显色。使用针对小鼠抗体的二抗检测P120连环蛋白一抗，并用红色显色。
使用单个抗体时，15个DCIS病变中有15个具有弥漫性环状膜E-钙黏蛋白染色（棕色染色）或P120连环蛋白染色（红色染色）。当使用单个P120连环蛋白或E-钙黏蛋白抗体时，所有12例LCIS病例均显示细胞质P120红色染色或E-钙黏蛋白染色缺失。当用混合抗体染色时，所有15个DCIS样本均显示弥漫性红色和棕色膜染色，无细胞质染色；所有12个LCIS样本均显示P120连环蛋白的弥漫性细胞质红色染色，但E-钙黏蛋白无膜染色。
