透明质酸结合蛋白和CD44s与乳腺浸润性微小乳头状癌高淋巴结转移的关系

目的：探讨透明质酸结合蛋白（HABP）和CD44s在乳腺浸润性微小乳头状癌（IMPC）的表达特征及与其高淋巴结转移的相互关系.方法：采用免疫组化染色方法检测21例IMPC及13例假性IMPC（Pseudo-IMPC）中HABP和CD44s的表达.结果：HABP在16例（76%）IMPC的癌细胞团与间质相接的外侧面以及间质细胞均高表达,而仅在3例（23%）Pseudo-IMPC中癌细胞膜或间质细胞弱表达,两组间差异明显（P=0.0042）.CD44s在15例（70%）IMPC中癌细胞连接面高表达,在8例（62%）Pseudo-IMPC中癌细胞膜全周表达阳性.此外,临床数据表明有18例IMPC及5例Pseudo-IMPC表现出淋巴结转移,且两组间差异显著（P=0.0078）.结论：HABP及CD44s的特殊表达作为两个重要的危险因子促进了IMPC的淋巴结转移.

High Incidence of Lymph Node Metastasis in Invasive Micropapillary Carcinoma Related with HABP and CD44s

To investigate the expressions of hyaluronic acid-binding protein(HABP) and CD44s in invasive micropapillary carcinoma(IMPC) of breast cancer and to demonstrate causality between its expressions and high rate of lymph-node metastasis in IMPC of breast cancer.The expressions of HABP and CD44s in 21 IMPC cases and 13 Pseudo invasive micropapillary carcinoma(Pseudo-IMPC) cases of breast cancer tissues were detected in 34 patients by the immunohistochemical SP method.The relationship between both the expressions of HABP and CD44s and the lymph-node metastasis of IMPC was compared by Fisher′s exact test.HABP was strongly expressed in cell membrane and intercellular substance of cancer cells in 16 of 21 IMPC cases,but weakly expressed in cell membrane and intercellular substance of 3 of 13 Pseudo-IMPC cases.There was a significant difference in the HABP expression between IMPC and Pseudo-IMPC cases(P= 0.0042).CD44s was mainly localized to intercellular membrane of cancer cells in 15 of 21 IMPC cases,but strongly expressed in cell membrane of cancer cells in 8 of 13 Pseudo-IMPC cases.There was no significant difference in CD44s expression IMPC and Pseudo-IMPC cases.Moreover,18 of 21 IMPC patients and 5 of 13 Pseudo-IMPC patients showed lymph node metastasis.There was a significant difference in the lymph node metastasis between IMPC and Pseudo-IMPC cases(P= 0.0078).These results indicate that the distinctive expressions of HABP and CD44s in IMPC are closely related to lymph node metastasis as important risk factors,and may provide important evidence regarding the diagnosis and treatment of IMPC.