共1页/1条首页上一页1下一页尾页
回复:32 阅读:6406
B2945Clinical and biological significance of E-cadherin protein expression in invasive lobular carcinom..

cqzhao 离线

帖子:5518
粉蓝豆:1071
经验:5755
注册时间:2008-09-29
加关注  |  发消息
楼主 发表于 2010-11-11 04:09|举报|关注(0)
浏览排序[ 顺序 逆序 楼主 支持 精彩 ]  快捷回复
姓    名: ××× 性别:   年龄:  
标本名称:  
简要病史:  
肉眼检查:  

Am J Surg Pathol. 2010 Oct;34(10):1472-9.

Clinical and biological significance of E-cadherin protein expression in invasive lobular carcinoma of the breast.

Rakha EA, Patel A, Powe DG, Benhasouna A, Green AR, Lambros MB, Reis-Filho JS, Ellis IO.

Department of Histopathology, Nottingham University Hospitals NHS Trust, UK. emadrakha@yahoo.com

Abstract

BACKGROUND: Although virtually all cases of lobular carcinoma in situ lack E-cadherin expression, a proportion of morphologically typical invasive lobular carcinomas (ILCs) retain its expression. The frequency and significance of E-cadherin expression in ILC remain to be elucidated. In this study, we have assessed E-cadherin protein expression in a well-characterized series of histologically defined ILC (239 cases) with a long-term clinical follow-up to determine the frequency, clinical and biological significance of its expression. E-cadherin-positive ILCs (ILC+) were subsequently examined to assess the expression of component members of the E-cadherin membrane complex (E-cadherin, p120, α, β, and γ-catenins) to determine its integrity.

RESULTS: Thirty-eight ILC cases (16%) showed positive E-cadherin expression (ILC+). Membranous expression of E-cadherin was mainly circumferential with frequent coexisting perimembranous cytoplasmic expression. No association between E-cadherin expression and any of the clinicopathologic variables, immunophenotype, or tumor behavior was identified, apart from an association with lobular histologic subtype and vascular invasion. Analysis of the E-cadherin-catenin complex showed abnormal expression of one or more of the catenin complex members in the majority of cases. The most frequent observation was the diffuse cytoplasmic expression of catenins, in particular p120, which showed similar expression to that reported in E-cadherin-negative ILCs.

CONCLUSIONS: These results provide evidence that E-cadherin is expressed in a proportion of ILC, however, unlike ductal carcinoma, its expression seems to be of limited significance and it is usually associated with evidence of impaired integrity of the E-cadherin-catenin membrane complex. Our data offer a possible explanation for the presence but lack functionality of E-cadherin in some cases of ILC and imply that immunohistochemical expression of E-cadherin per se in ILC histologic phenotypic tumors should not preclude its diagnosis.

PMID: 20871222 [PubMed - indexed for MEDLINE]

标签:乳腺浸润性小叶癌 E-cadherin p120
本帖最后由 于 2010-11-28 08:16:00 编辑
0
添加参考诊断
×参考诊断
  

XLJin8 离线

帖子:2275
粉蓝豆:1535
经验:2417
注册时间:2009-03-04
加关注  |  发消息
1 楼    发表于2010-11-28 08:01:00举报|引用
返回顶部 | 快捷回复
本帖最后由 于 2010-11-28 17:49:00 编辑

非常有意义的研究报道,对传统上用“癌细胞膜表达E- cadherin” 做为鉴别IDC和ILC的标记提出了挑战。

形态学典型的ILC16% 可细胞膜表达E-cadherin, 但是P-120仍为细胞质表达(ILC型)

因此,具有经典形态的浸润性小叶癌E-cadherin 和P120 的表道方式可以归纳为。

1)Ecadherin  细胞膜不表达(或明显弱表达);P120细胞质表达,

2)E-cadherin 膜表达;P120 细胞质表达。

第二情况的发生率可高达16%, 因此,我们应该注意到形态学典型的浸润小叶癌可以细胞膜表达E-cadherin, 此时标记P120 有利于鉴别。但是其临床预后与E-cadherin-的ILC无明显区别(除浸润血管外)。作者认为E-cad+ILC中E-cadherin是无功能性的。 

此外,要注意少数乳腺导管上皮内肿瘤,单纯根据HE形态无法区别是DCIS还是LCIS(见图)。 用IHC标记E-cadherin 和34BE12可有4种表达形式:

1)E-cadherin+34BE12-(DCIS表型)

2)E-cadherin-34BE12+(LCIS表型)

3)E-cadnerin-s4BE12-(阴性杂交)

4) E-cadherin+34BE12+(阳性杂交)

第3和第4种免疫表型被认为是Mammary intraepithelial neoplasia MIN) 。

Dr. Tavasoli推测MIN可能为乳腺干细胞性的病变。MIN可能反应乳腺干细胞肿瘤或最早期后干细胞。它具有塑形和演变成导管内或小叶内上皮肿瘤和浸润性乳腺癌潜能。MIN临床处理,注释,分级、处理根据免疫表型。目前认为:E-cadherin导管上皮病变特征E-cadherin + DIN处理;E-cadherin - LIN处理

(参考文献:AFIP Tumors of the breast, series 4Page 94-95.)

DR. Zhao 提供了非常好的文章,它纯清了我们在日常工作中的疑问“形态学典型的浸润性小叶, IHC 却细胞膜表达E-cadherin,并提出对于这种情况标记P120 可帮助鉴别。

由于未看全文,可能理解有误,请Dr.Zhao 指正,谢谢!

  • 图1
0
回复
signature
xljin8
回复:32 阅读:6406
共1页/1条首页上一页1下一页尾页
【免责声明】讨论内容仅作学术交流之用,不作为诊疗依据,由此而引起的法律问题作者及本站不承担任何责任。
快速回复
进入高级回复
您最多可输入10000个汉字,按 "Ctrl" + "Enter" 直接发送
搜索回复/乘电梯 ×
按内容
按会员
乘电梯
合作伙伴
友情链接