Bose S, Lesser M L, Norton L, Rosen P P
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Arch Pathol Lab Med. 1996 Jan;120(1):81-5.
Mammography and breast-conserving therapy have focused attention on the classification of intraductal carcinoma (IDC) and emphasized the prognostic importance of comedo versus noncomedo variants. We used histochemical markers to define the immunophenotype of 43 IDCs with respect to comedo versus noncomedo status and patterns of angiogenesis.
Reactions in comedo carcinomas were significantly negative for estrogen receptor and progesterone receptor, and positive for p53 and HER-2/neu more often than the noncomedo variant. All seven IDCs associated with Paget's disease showed positive reactions for HER-2/neu. Basement membrane immunoreactivity for type IV collagen and laminin was discontinuous in most examples of IDC regardless of type, with a trend toward more intense staining in comedo than in noncomedo carcinomas. Periductal angiogenesis was not significantly related to the type of IDC but was more pronounced with comedo carcinomas.
These observations indicate that there are immunophenotypic correlates to the current structural classification of IDC. The immunophenotype of IDC is helpful in subclassifying an IDC and could prove useful as a prognostic indicator for local control in patients treated by breast-conserving therapy.
乳腺钼靶摄影和保乳治疗已将注意力集中在导管内癌(IDC)的分类上,并强调了粉刺型与非粉刺型变体的预后重要性。我们使用组织化学标记物来确定43例IDC在粉刺型与非粉刺型状态以及血管生成模式方面的免疫表型。
粉刺癌中雌激素受体和孕激素受体反应显著为阴性,p53和HER-2/neu反应阳性的情况比非粉刺型变体更常见。所有7例与佩吉特病相关的IDC对HER-2/neu均呈阳性反应。无论类型如何,在大多数IDC病例中,IV型胶原和层粘连蛋白的基底膜免疫反应性均不连续,粉刺癌的染色趋势比非粉刺癌更强烈。导管周围血管生成与IDC类型无显著相关性,但在粉刺癌中更明显。
这些观察结果表明,IDC目前的结构分类存在免疫表型相关性。IDC的免疫表型有助于对IDC进行亚分类,并可能被证明是保乳治疗患者局部控制的有用预后指标。