Visscher D W, Wallis T L, Crissman J D
Department of Pathology, Harper Receiving Hospital, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
Cancer. 1996 Jan 15;77(2):315-20. doi: 10.1002/(SICI)1097-0142(19960115)77:2<315::AID-CNCR14>3.0.CO;2-4.
Little is known about cellular level genetic alterations in preinvasive breast lesions, particularly lobular carcinoma in situ.
We employed fluorescence in situ hybridization (FISH) using pericentromeric (alpha satellite) probes to assess numerical alterations of chromosomes 1, 7, 8, 16, 17, and X in deparaffinized archival tissue sections of 9 lobular carcinomas in situ (LCIS), 10 ductal carcinomas in situ (DCIS), and a spectrum of proliferative lesions (including 3 ductal hyperplasias, 1 adenosis, 1 radial scar, and 2 atypical hyperplasias). Three of the LCIS lesions and five of the DCIS lesions were from patients who had a concurrent invasive neoplasm as a component of the tumor.
None of the proliferative lesions exhibited detectable chromosome gains, and only 1 showed evidence of signal loss consistent with monosomy (chromosome 7 in the adenosis lesion). Six LCIS patients (67%) displayed evidence of monosomy, with involvement of chromosome 17 in 6 of 6 patients, chromosome 8 in 2 of 6 patients, and chromosome 7 in 2 of 6 patients. Two LCIS patients, each of whom had a concurrent invasive neoplasm, exhibited signal gains consistent with trisomy for chromosomes 1 and 8 (1 patient each). Chromosome aneuploidies were observed in 7 of 10 (70%) DCIS patients, including 2 of 5 patients (40%) without concurrent invasive neoplasm and 5 of 5 patients (100%) with concurrent invasive neoplasm. The pattern of numerical chromosome alteration in DCIS included two patients with losses only, 2 patients with gains only, and 3 patients with both gains and losses (i.e., involving different chromosomes). Chromosome 17 aneuploidy was observed in all DCIS and all LCIS patients who exhibited abnormalities; however, DCIS patients showed more frequent aneuploidies for chromosomes X and 16 (0 LCIS patients vs. 4 DCIS patients with each).
Distinctive pathologic subsets of preinvasive breast neoplasia have divergent patterns of genetic instability. Foci of residual in situ neoplasia that accompany invasive disease may have a greater degree of genetic instability than neoplasms that lack progression to invasive phenotype.
对于乳腺浸润前病变,尤其是小叶原位癌的细胞水平基因改变了解甚少。
我们使用着丝粒周围(α卫星)探针进行荧光原位杂交(FISH),以评估9例小叶原位癌(LCIS)、10例导管原位癌(DCIS)以及一系列增殖性病变(包括3例导管增生、1例腺病、1例放射状瘢痕和2例非典型增生)的石蜡包埋存档组织切片中1、7、8、16、17号染色体和X染色体的数目改变。其中3例LCIS病变和5例DCIS病变来自伴有浸润性肿瘤的患者。
所有增殖性病变均未检测到染色体增加,仅1例显示与单体性一致的信号缺失证据(腺病病变中的7号染色体)。6例LCIS患者(67%)显示单体性证据,6例患者中有6例涉及17号染色体,6例中有2例涉及8号染色体,6例中有2例涉及7号染色体。2例伴有浸润性肿瘤的LCIS患者分别表现出与1号和8号染色体三体性一致的信号增加。10例DCIS患者中有7例(70%)观察到染色体非整倍体,包括5例无浸润性肿瘤的患者中有2例(40%)以及5例伴有浸润性肿瘤的患者中有5例(100%)。DCIS中染色体数目改变的模式包括2例仅有缺失、2例仅有增加以及3例既有增加又有缺失(即涉及不同染色体)。在所有表现出异常的DCIS和LCIS患者中均观察到17号染色体非整倍体;然而,DCIS患者中X染色体和16号染色体的非整倍体更为常见(0例LCIS患者,4例DCIS患者各有一条)。
乳腺浸润前肿瘤的不同病理亚组具有不同的基因不稳定模式。伴有浸润性疾病的原位肿瘤残留灶可能比未进展为浸润性表型的肿瘤具有更高程度的基因不稳定。