摘要:
目的 探讨前列腺干细胞抗原(PSCA)在不同性质乳腺组织中的表达和临床意义.方法 回顾性分析2000年1月至2014年12月北京市顺义区医院病理科诊断的、乳腺外科手术切除的、术前未经任何治疗的普通型导管增生(UDH)、非典型导管增生(ADH)、DCIS和非特殊型浸润性癌(IC-NST)患者共175例临床资料,其中有38例因组织块过小或脱落未能获得准确数据而被剔除,故实际纳入分析的样本量为137例,包括20例UDH、20例ADH、30例DCIS和67例IC-NST.同时随机选取20例IC-NST癌旁正常乳腺组织作为对照.应用免疫组织化学染色法(LSAB法)检测标本中PSCA蛋白的表达情况,分析不同性质乳腺组织中PSCA蛋白表达的差异,以及IC-NST中PSCA蛋白表达与临床病理学特征的相关性.组间PSCA蛋白表达水平的比较采用X2检验,IC-NST中PSCA蛋白表达与临床病理学特征的关系采用Spearman秩相关分析.结果 PSCA蛋白在正常乳腺组织中不表达,在UDH、ADH、DCIS和IC-NST中高表达率分别为10.0%(2/20)、20.0%(4/20)、56.7%(17/30)和52.2%(35/67),其表达水平的差异具有统计学意义(X2=32.153,P<0.001).多组间两两比较结果显示,DCIS组和IC-NST组PSCA蛋白表达均高于正常乳腺组织(X2=17.172、17.480,P均<0.005)和UDH组(X2=11.092、11.243,P均<0.005).Spearman秩相关分析显示,IC-NST组PSCA蛋白表达与淋巴结转移呈正相关(r=0.326,P=0.007).结论 PSCA蛋白可能参与了乳腺癌的发生、发展进程,可能是一个预测导管内增生性病变进展成乳腺癌的新指标.%Objective To study the expression of prostate stem cell antigen ( PSCA) in different breast tissues and its clinical significance. Methods We retrospectively analyzed the clinical data of 175 patients who were diagnosed in Department of Pathology, received no treatment before operation and underwent surgical resection in Department of Breast Surgery, Shunyi District Hospital from January 2000 to December 2014, including the patients with usual ductal hyperplasia ( UDH ) , atypical ductal hyperplasia ( ADH ) , ductal carcinoma in situ ( DCIS ) and invasive carcinoma of no specific type (IC-NST ) . Thirty-eight cases were excluded from the study for small or abscised samples. Totally 137 cases were enrolled, including 20 cases of UDH, 20 ADH, 30 DCIS and 67 IC-NST. The adjacent normal tissues from 20 cases of IC-NST served as control. The expression of PSCA in specimens was detected by immunohistochemical staining ( LSAB method) . The relationship between PSCA expression in different breast tissues and clinicopathological characteristics of the patients was analyzed. PSCA expressions between groups were compared using X2 test. The relationship between PSCA expression and clinical characteristics of IC-NST patients was analyzed using Spearman rank correlation analysis. Results PSCA was not expressed in normal breast tissue. The high expression rates of PSCA in UDH, ADH, DCIS andIC-NST were 10. 0% (2/20), 20. 0%(4/20), 56. 7%(17/30) and 52. 2%(35/67) respectively, indicating a significant difference (X2=32. 153, P<0. 001). The expression of PSCA in DCIS or IC-NST was significantly higher than that in normal tissue (X2=17. 172, 17. 480;both P<0. 005) and the expression of PSCA in DCIS or IC-NST was significantly higher than that in UDH ( X2 =11. 092, 11. 243, both P<0. 005). Spearman correlation analysis showed that the expression of PSCA was positively correlated with lymph node metastasis inIC-NST(r=0. 326, P=0. 007). Conclusion PSCA may play a role in the occurrence and development of breast cancer and can serve as a new predictor of ductal proliferative lesions being developed into breast cancer.