Evans A J, Pinder S E, Ellis I O, Sibbering D M, Elston C W, Poller D N, Wilson A R
Department of Radiology, Nottingham City Hospital.
Clin Radiol. 1994 Aug;49(8):559-62. doi: 10.1016/s0009-9260(05)82937-x.
C-erbB-2 oncogene expression is found in 60% of DCIS cases. C-erbB-2 expression in DCIS has been shown to correlate with comedo subtype, large cell size, lymphoid infiltrate, nuclear pleomorphism, multinucleation and high mitotic rate. These findings have led to the suggestion that the subgroup of DCIS that expresses c-erbB-2 may be a biologically definable category with prognostic significance. The purpose of this study was to identify any differences in the mammographic appearances between DCIS which expresses c-erbB-2 and DCIS that does not express this oncogene.
C-erbB-2 staining characteristics and preoperative mammograms were available for review in 126 patients with pure DCIS. All the mammograms were reviewed by a radiologist knowing the patient had DCIS but without any further pathological or immunohistochemical information.
C-erbB-2 positive DCIS showed the following features more commonly than c-erbB-2 negative disease: calcification (65 of 71 (92%) vs 28 of 39 (72%), P < 0.01), ductal distribution of calcification (51 of 65 (78%) vs 16 of 28 (57%), P < 0.05), rod-shaped calcification (53 of 65 (82%) vs 15 of 28 (54%), P < 0.01) and granular calcification (63 of 65 (97%) vs 24 of 28 (86%), P < 0.05). C-erbB-2 negative DCIS more commonly showed an abnormal mammogram without calcification than c-erbB-2 positive disease (11 of 39 (28%) vs 6 of 71 (8%), P < 0.01).
We have demonstrated significant differences in the mammographic features of c-erbB-2 positive and negative disease. As c-erbB-2 expression has been shown to correlate with aggressive histological features, the differences in the mammographic appearances between c-erbB-2 positive and c-erbB-2 negative DCIS may be of practical value.
在60%的导管原位癌（DCIS）病例中可发现C-erbB-2癌基因表达。DCIS中的C-erbB-2表达已显示与粉刺型、大细胞大小、淋巴细胞浸润、核多形性、多核化及高有丝分裂率相关。这些发现提示，表达C-erbB-2的DCIS亚组可能是一个具有预后意义的生物学可定义类别。本研究的目的是确定表达C-erbB-2的DCIS与不表达该癌基因的DCIS在乳腺钼靶表现上是否存在差异。
126例单纯DCIS患者的C-erbB-2染色特征及术前乳腺钼靶片可供回顾性分析。所有乳腺钼靶片由一位知晓患者患有DCIS但无任何进一步病理或免疫组化信息的放射科医生进行阅片。
C-erbB-2阳性的DCIS比C-erbB-2阴性病变更常出现以下特征：钙化（71例中的65例（92%） vs 39例中的28例（72%），P < 0.01）、钙化的导管分布（65例中的51例（78%） vs 28例中的16例（57%），P < 0.05）、杆状钙化（65例中的53例（82%） vs 28例中的15例（54%），P < 0.01）及颗粒状钙化（65例中的63例（97%） vs 28例中的24例（86%），P < 0.05）。C-erbB-2阴性的DCIS比C-erbB-2阳性病变更常出现无钙化的异常乳腺钼靶表现（39例中的11例（28%） vs 71例中的6例（8%），P < 0.01）。
我们已证实在C-erbB-2阳性和阴性病变的乳腺钼靶特征上存在显著差异。由于C-erbB-2表达已显示与侵袭性组织学特征相关，C-erbB-2阳性和阴性DCIS在乳腺钼靶表现上的差异可能具有实际价值。
