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乳腺癌的组织病理学及预后指标,特别提及p53标记物

Histopathology and Prognostic Indices of Carcinoma Breast with Special Reference to p53 Marker.

作者信息

Radha Rajesh Kanna Nandagopal, P Viswanathan, B Krishnaswamy

机构信息

Assistant Professor, Department of Pathology, Chettinad Hospital and Research Institute , Chennai, India .

Professor, Department of Pathology, Rajah Muthiah Medical College, Annamalai University , Chidambaram, India .

出版信息

J Clin Diagn Res. 2014 Jul;8(7):FC04-8. doi: 10.7860/JCDR/2014/9114.4609. Epub 2014 Jul 20.

Abstract

INTRODUCTION

Cancer of the breast is one of the commonest carcinomas in women, both in western world and in India. The high frequency of breast cancer in women has prompted an intensive study of possible modifiable risk factors (clinical parameters, morphological typing, and biological markers) for assessment of prognosis, prevention strategies, and treatment modalities. p53 is one of the most significant prognostic markers for breast carcinomas.

AIMS AND OBJECTIVES

This study was undertaken to ascertain the prevalence of p53 mutated protein in breast carcinomas by immunohistochemistry and correlating the results with clinical and histological parameters and also determine its influence on axillary node metastasis.

MATERIALS AND METHODS

Clinico-pathological evaluation of 50 cases of infiltrating ductal carcinoma of the breast, with reference to p53 mutated protein expression by means of immunohistochemistry was undertaken.

RESULTS

The percentage positivity of p53 immunohistochemistry of this study was 22% which is similar to the reported statistics of various other studies. The immunohistochemistry results also showed an equivocal p53 status in both the positive and negative cases of lymph node metastases. The carcinomas with p53 positivity demonstrated aggressive characteristics, including larger size, higher grade, in comparison with p53 negative cases. The probability of getting positive p53 status was higher for those with severe lymphocytic reaction of tumours, for patients less than 35 years of age and for those with tumour on the left side. This study clearly indicates that p53 over expression in breast cancers are mostly aggressive tumours and they confer poor prognosis and likelihood of a poor response to endocrine therapy and chemotherapy.

摘要

引言

乳腺癌是女性中最常见的癌症之一,在西方世界和印度均如此。女性乳腺癌的高发病率促使人们对可能的可改变风险因素(临床参数、形态学类型和生物学标志物)进行深入研究,以评估预后、预防策略和治疗方式。p53是乳腺癌最重要的预后标志物之一。

目的

本研究旨在通过免疫组织化学确定乳腺癌中p53突变蛋白的患病率,并将结果与临床和组织学参数相关联,同时确定其对腋窝淋巴结转移的影响。

材料与方法

对50例乳腺浸润性导管癌进行临床病理评估,通过免疫组织化学检测p53突变蛋白的表达。

结果

本研究中p53免疫组织化学的阳性率为22%,与其他各项研究报告的统计数据相似。免疫组织化学结果还显示,在淋巴结转移的阳性和阴性病例中,p53状态均不明确。与p53阴性病例相比,p53阳性的癌表现出侵袭性特征,包括更大的尺寸、更高的分级。肿瘤淋巴细胞反应严重的患者、年龄小于35岁的患者以及左侧有肿瘤的患者,p53阳性状态的概率更高。本研究清楚地表明,乳腺癌中p53的过度表达大多是侵袭性肿瘤,它们预示着预后不良以及对内分泌治疗和化疗反应不佳的可能性。

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