Ki-67标记增殖指数在乳腺叶状肿瘤中的免疫表达

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摘要

页状肿瘤(PTs)是一种罕见的乳腺肿瘤,其临床病程随肿瘤类型的不同而变化。世界卫生组织(WHO)将PTs分为良性、交界性和恶性,是基于几种组织学特征的结合,包括基质细胞性、核异型性、有丝分裂活性、基质过度生长和肿瘤边缘外观。然而,对于单个组织学参数,没有明确的标准或明确的截止点。因此,基于形态学整合的PTs诊断仍然具有挑战性。除了分级,对增殖标记物如Ki-67的进一步研究对于识别那些有潜在攻击行为的人是必不可少的。本研究旨在评估不同亚型PTs的组织病理学特征和Ki-67表达的相关性。本研究对30例PTs进行了研究。结合组织学特征,常规H&E染色用于肿瘤的诊断和分类。Ki-67的免疫染色也采用基于聚合物的检测方法。Ki-67标记指数(LI)根据肿瘤阳性细胞的百分比分为0- 10,11 - 30,31 - 50,51及以上,并与各病例的组织学分级和临床特征相关。本研究共检查了20例(66.7%)良性叶状瘤,3例(10%)交界性叶状瘤,7例(23.3%)恶性叶状瘤。20例BPT中肿瘤复发3例(15%)。BPT的Ki-67 LI平均为5%(范围1-10%),边缘PT为17.5%(范围15-20%)。MPT的Ki-67 LI范围为15-35%,平均LI为25%。Ki-67在不同级别PT中的表达差异有统计学意义(p=0.01)。因此,在叶状虫的常规组织病理学报告中应进行Ki-67 LI检查,以便对叶状虫进行亚分类。
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Immunoexpression of Ki-67 Labelling Proliferation Index in Phyllodes Tumour of Breast by Polymer-based Detection Method
Phylloides tumours (PTs) are rare breast neoplasms with a variable clinical course depending on the tumour category. The classification of PTs proposed by the World Health Organization (WHO) into benign, borderline and malignant is based on a combination of several histologic features, including Stromal cellularity, nuclear atypia, mitotic activity, stromal overgrowth and tumour margin appearance. However, there are no defined criteria or clear cut-offs for individual histologic parameters. Thus, the diagnosis of PTs based on the integration of morphology remains challenging. Along with the grade, additional study of proliferative markers such as Ki-67 are essential to identify those with potential for aggressive behaviour. This study was undertaken to assess the histopathological characters and correlate Ki-67 expression in different subtypes of PTs. In this study, 30 cases of PTs were studied. Regarding histologic features, routine H&E stains were taken into consideration for diagnosis and classification of tumours. Immunostaining for Ki-67 was also performed by polymer-based detection method. Ki-67 labelling index (LI) was categorized as 0-10, 11-30, 31-50, 51 and above depending on the percentage of positive tumor cells and was correlated with histologic grade and clinical features in each case. Twenty cases (66.7%) of benign phyllodes tumour (BPT), 3 cases (10%) of borderline PT, and 7 cases (23.3%) cases of malignant phylloides tumour (MPT) were examined in this study. Among 20 cases of BPT, 3 cases (15%) were recurrent tumours. Average Ki-67 LI in BPT was 5% (range 1-10%) and borderline PT was 17.5% (range 15-20%). MPT exhibited Ki-67 LI range of 15-35% with average LI of 25%. A significant association was seen between expression of Ki-67 in different grades of PT(p=0.01). So, Ki-67 LI should be performed in routine histopathology reporting of phylloides for sub-categorisation of phylloides.
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