Poller D N, Snead D R, Roberts E C, Galea M, Bell J A, Gilmour A, Elston C W, Blamey R W, Ellis I O
Department of Histopathology, City Hospital, Nottingham, UK.
Br J Cancer. 1993 Jul;68(1):156-61. doi: 10.1038/bjc.1993.305.
The expression of oestrogen receptor protein (ER) was examined in 151 cases of symptomatic or screening detected pure ductal carcinoma in situ (DCIS) of the breast by immunocytochemical assay (ERICA), in formalin-fixed paraffin-embedded tissue, with the monoclonal antibody H 222 (Abbott). Forty-eight tumours (31.8%) of cases were ER positive. Twenty-seven (17.9%) of cases showed high level ER expression and 21 (13.9%) of cases showed low level ER immunoreactivity. Significant associations of positive tumour ER immunoreactivity and non-comedo architecture chi 2 = 6.76; (d.f. = 1): P < 0.001, small cell size chi 2 = 4.49; (d.f. = 1): P = 0.034, higher S-phase fraction chi 2 = 4.71; (d.f. = 1): P = 0.03 and lack of c-erbB-2 protein overexpression chi 2 = 7.96; (d.f. = 1): P < 0.01 were identified. No significant associations of ER expression and patient age, histological grade of necrosis in DCIS, or DNA ploidy were found. ER expression is detectable in less than one third of symptomatic and screening detected cases of DCIS, implying that endocrine therapy of DCIS may be a more appropriate form of management for morphological subtypes of DCIS which show higher rates of oestrogen receptor expression, particularly those of non-comedo and small cell type.
采用免疫细胞化学分析法（ERICA），使用单克隆抗体H 222（雅培公司），对151例有症状或筛查发现的乳腺单纯导管原位癌（DCIS）患者福尔马林固定石蜡包埋组织中的雌激素受体蛋白（ER）表达情况进行了检测。48例肿瘤（31.8%）为ER阳性。27例（17.9%）病例显示高水平ER表达，21例（13.9%）病例显示低水平ER免疫反应性。肿瘤ER免疫反应性阳性与非粉刺型结构（χ2 = 6.76；自由度 = 1：P < 0.001）、小细胞大小（χ2 = 4.49；自由度 = 1：P = 0.034）、较高的S期分数（χ2 = 4.71；自由度 = 1：P = 0.03）以及缺乏c-erbB-2蛋白过表达（χ2 = 7.96；自由度 = 1：P < 0.01）之间存在显著相关性。未发现ER表达与患者年龄、DCIS中坏死的组织学分级或DNA倍体之间存在显著相关性。在有症状和筛查发现的DCIS病例中，不到三分之一可检测到ER表达，这意味着对于ER表达率较高的DCIS形态学亚型，尤其是非粉刺型和小细胞型，DCIS的内分泌治疗可能是一种更合适的治疗方式。
