不同检查方法对乳腺癌侵犯NAC 临床检出率的影响

Effect of different examination methods on clinical detection rate of nipple-areolar complex invasion in breast cancer

摘要:

目的 探讨不同检查方法对乳腺癌侵犯乳头乳晕复合体（NAC）临床检出率的影响。方法 收集 240 例女性原发性乳腺癌患者病理标本，分为观察组与对照组，每组各120 例。对照组于乳头的正中矢状面 取材，取材深度5 mm，观察组取乳头与乳晕皮肤以及连同皮下10 mm 的整块组织，采用自创5 刀法取材；两 组均分别经常规苏木精- 伊红染色（HE）及免疫组化染色（IHC）[ 细胞角蛋白19（CK-19）为目标蛋白] 处理后镜检。结果 观察组经HE 及IHC 处理后的检出率分别为8.33% 与24.17%，两者比较差异有统计学 意义（P <0.05）；对照组经HE 及IHC 处理后的检出率分别为6.67% 与8.33%，两者比较差异无统计学意义 （P >0.05）；经HE 处理后，两组患者检出率比较，差异无统计学意义（P >0.05）；经IHC 处理后，观察组检出 率高于对照组，差异有统计学意义（P <0.05）；样本经IHC 处理可观察到NAC 的微侵犯灶。结论 采用乳头 矢状面5 刀法取材，联合以CK-19 为目标蛋白的IHC 检查可提高乳腺癌侵犯NAC 检出率，更准确地反应乳 腺癌NAC 受累的真实情况。

Abstract:

Objective To investigate the effect of different examination methods on the clinical detection rate of nipple-areolar complex (NAC) invasion in breast cancer. Methods A total of 240 pathological specimens of primary breast cancer were divided into observation group and control group, with 120 cases in each group. The specimens were taken from the median sagittal plane in the control group for depth of 5 mm, and shose in the observation group were taken from the nipple and areola skin and subcutaneous tissue together with the whole 10 mm by homemade 5 blade. The two groups were treated with regular HES and IHC (CK-19 as target protein) and microscopically examined after the treatment. Results The detection rates in the observation group by HES and IHC were respectively 8.33% and 24.17%, and the detection rate by IHC was significantly higher than that by HES (χ2 = 9.052, P = 0.008). The detection rates in the control group by HES and IHC were 6.67% and 8.33%, and the detection rate by IHC was not statistically significantly higher than that by HES (χ2 = 1.076, P = 0.087).After HES, the detection rate was not significantly different between the two groups (χ2 = 0.240, P = 0.103). After IHC, the detection rate in the observation group was significantly higher than that of control group (χ2 = 11.375, P = 0.002). NAC micro invasive lesions can be observed in sample treated by IHC. Conclusion Papillary sagittal 5 blade combined with IHC examination with CK-19 can improve detection rate of NAC invasion in breast cancer, which can more accurately reflect the involvement of NAC in breast cancer.