乳腺分叶状肿瘤EGFR、Ki67表达及意义.docVIP

乳腺分叶状肿瘤EGFR、Ki67表达及意义 　 作者：蔡敏　孔香云　王妍　刘志艳　周志强 　马榕　张庆慧 【摘要】 　　目的：探讨乳腺分叶状肿瘤（PT）中EGFR、Ki67的表达和意义。方法：采用免疫组织化学EnVision两步法，检测33例乳腺分叶状肿瘤间质细胞中EGFR和Ki67的表达，比较良性、交界性和恶性PT中EGFR、Ki67表达的差异。结果:EGFR在良性PT中的阳性表达率为33.3％（5/15），交界性PT为80.0％（8/10），恶性PT为100％（8/8），恶性PT的强阳性表达率为62.5％（5/8），EGFR在良恶性PT病变中的表达有统计学意义(Plt;0.05)。Ki67蛋白的阳性表达率在良性PT组为13.3％（2/15）,均为弱阳性表达，交界性PT为60.0％（6/10）,恶性PT为100%（8/8），其中50.0％（4/8）为强阳性表达, Ki67蛋白表达在良恶性PT病变中有统计学意义（Plt;0.05）。EGFR 和Ki67抗原表达与PT组织学分级相关。在良性PT中EGFR和Ki67表达率低,交界性、恶性PT表达率高，随着PT级别的增高，其表达率和表达强度增加，两指标呈正相关（r=0.6073，Plt;0.001）。结论：EGFR和Ki67有可能作为判断PT恶性度的指标。EGFR在交界性和恶性PT中的高表达，提示针对EGFR的靶向治疗在恶性难治性PT术后辅助治疗中有一定的临床应用前景。 【关键词】 乳腺肿瘤·分叶状肿瘤·受体·表皮生长因子·Ki67 　　Expression of EGFR and Ki67 in phyllodes tumors of the breast and its clinical significance. 【ABSTRACT】 Objectives: To evaluate the expression of EGFR and Ki67 as well as their clinical significance in phyllodes tumors (PT) of the breast. Methods: The expression of EGFR and Ki67 in stroma was observed in 33 mammary PT (benign, 15; borderline, 10; and malignant, 8) using EnVision immunohisto-chemistry, to evaluate the correlation of the expression with the degree of malignancy. Results: The positive rate of EGFR expression was 33.3％ (5 /15) in benign PT, 80.0％ (8/10) in borderline PT， and 100％（8/8）in malignant PT, respectively. The expression of EGFR showed a significant difference between benign and malignant lesions (Plt;0.05). The positive rate of Ki 67 was 13.3％（2/15）in benign PT, 80.0％（6/10）in borderline PT，and 100％（8/8）in malignant PT , all of benign PT stained weakly positive，50.0％ of malignant PT stained strongly positive. The difference was also significant (Plt;0.05). The expression of EGFR and Ki67 were associated with the progression in grades of PT of the breast. The expressions in benign PT were lower than those in borderline and malignant PT. The staining intensity of EGFR was correlated positively with that of Ki67 (r=0.6073, Plt;0.001). Conclusion: EGFR and Ki67 may be used as indicators to detect the degree o