Quinn C M, Ostrowski J L, Harkins L, Rice A J, Loney D P
Department of Histopathology, General Infirmary at Leeds, UK.
Histopathology. 1998 Dec;33(6):531-6. doi: 10.1046/j.1365-2559.1998.00505.x.
This study (1) investigates the incidence of bcl-2 protein expression in a series of 108 cases of ductal carcinoma in situ (DCIS), including 25 with early invasive carcinoma, and (2) evaluates the relationship of bcl-2 expression to the histological grade of DCIS and to the expression of oestrogen receptor (ER), c-erbB-2 and p53 proteins.
The expression of bcl-2, oestrogen receptor (ER), c-erbB-2 and p53 proteins was determined immunohistochemically. Cases were regarded as positive for individual antibodies when at least 10% of the DCIS cells showed positive staining. DCIS was graded histologically as well (n = 9), intermediately (n = 24), or poorly differentiated (n = 75). bcl-2 expression was documented in 57 cases (53%) and was strongly associated with the histological grade of DCIS (P < 0.0001). All cases of well-differentiated DCIS were bcl-2 positive and loss of bcl-2 expression was almost exclusively confined to poorly differentiated DCIS lesions. bcl-2 expression was also closely associated with positive ER status (P < 0.0001). Forty-seven of 57 (82%) bcl-2 positive cases were ER positive while 49/51 (96%) bcl-2 negative cases were ER negative. There was a significant inverse correlation between bcl-2 expression and both p53 protein expression (P = 0.0004) and c-erbB-2 expression (P < 0.0001). Nineteen of 24 (79%) p53 positive cases and 38/45 (84%) c-erbB-2 positive cases showed loss of bcl-2.
Loss of bcl-2 expression occurs in poorly differentiated DCIS and is related to negative ER status and to positive p53 and c-erbB-2 status. This pattern of bcl-2 expression and its association with other biological markers in DCIS is similar to that reported in invasive breast carcinoma.
本研究（1）调查108例导管原位癌（DCIS）（其中包括25例早期浸润癌）中bcl-2蛋白表达的发生率，（2）评估bcl-2表达与DCIS组织学分级以及雌激素受体（ER）、c-erbB-2和p53蛋白表达之间的关系。
采用免疫组织化学方法检测bcl-2、雌激素受体（ER）、c-erbB-2和p53蛋白的表达。当至少10%的DCIS细胞呈阳性染色时，病例被视为单个抗体阳性。DCIS的组织学分级为高分化（n = 9）、中分化（n = 24）或低分化（n = 75）。57例（53%）病例有bcl-2表达，且与DCIS的组织学分级密切相关（P < 0.0001）。所有高分化DCIS病例均为bcl-2阳性，bcl-2表达缺失几乎仅局限于低分化DCIS病变。bcl-2表达也与ER阳性状态密切相关（P < 0.0001）。57例bcl-2阳性病例中有47例（82%）为ER阳性，而51例bcl-2阴性病例中有49例（96%）为ER阴性。bcl-2表达与p53蛋白表达（P = 0.0004）和c-erbB-2表达（P < 0.0001）均呈显著负相关。24例p53阳性病例中有19例（79%）和45例c-erbB-2阳性病例中有38例（84%）显示bcl-2缺失。
bcl-2表达缺失发生在低分化DCIS中，且与ER阴性状态以及p53和c-erbB-2阳性状态相关。DCIS中这种bcl-2表达模式及其与其他生物学标志物的关联与浸润性乳腺癌中报道的情况相似。
