Wilbur D C, Barrows G H
Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, New York.
Mod Pathol. 1993 Mar;6(2):114-20.
The authors studied 30 consecutive archival cases of pure breast carcinoma in situ (CIS) for estrogen receptor (ER), progesterone receptor (PR), and c-erbB-2 oncogene product. Clinical factors of age and menstrual status and histologic features of tumor type and nuclear grade were determined. Some 77% represented ductal CIS, with 10% noninvasive papillary, and 13% lobular CIS. A total of 22 of 30 (73%) were ER+ and 19 (63%) were PR+; 24 (80%) were c-erbB-2+ with 11 (37%) showing strong staining; 75% of the ER-PR group had tumors of NG 3, versus 14% for the ER+PR+ plus ER+PR- groups. Nonstatistically significant trends correlating the strongly positive oncogene group with PM status, receptor negativity, and high nuclear grade were noted. The overall rate of receptor positivity, as well as the correlation with nuclear grade, is similar to that in invasive carcinomas c-erbB-2 protein expression shows a higher rate in in situ than is reported for invasive tumors, and shows a tendency to be expressed more strongly in tumors with other features of poor prognosis. Therefore, these factors may also have prognostic significance in CIS. Continued followup of this population to recurrence may provide further insight.
作者研究了30例连续存档的纯乳腺原位癌（CIS）病例，检测雌激素受体（ER）、孕激素受体（PR）和c-erbB-2癌基因产物。确定了年龄和月经状态等临床因素以及肿瘤类型和核分级等组织学特征。约77%为导管原位癌，10%为非浸润性乳头状癌，13%为小叶原位癌。30例中有22例（73%）ER阳性，19例（63%）PR阳性；24例（80%）c-erbB-2阳性，其中11例（37%）呈强染色；ER-PR组75%的肿瘤为核分级3级，而ER+PR+加ER+PR-组为14%。注意到强阳性癌基因组与绝经状态、受体阴性和高核分级之间存在非统计学显著趋势。受体阳性的总体率以及与核分级的相关性与浸润性癌相似；c-erbB-2蛋白表达在原位癌中的发生率高于浸润性肿瘤的报道，并且在具有其他预后不良特征的肿瘤中倾向于更强烈地表达。因此，这些因素在原位癌中可能也具有预后意义。对该人群进行持续随访直至复发可能会提供进一步的见解。
