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目的:探讨术前核芯针穿刺活检(CNB)免疫组织化学检测ER、PR、C-erbB-2、Ki-67在乳腺癌诊断中的临床应用价值。方法:35例乳腺癌患者术中局部切除肿瘤后,送快速病理前,在手术室中采用巴德枪对肿瘤进行核芯针穿刺取材,模拟术前乳腺癌CNB,取得病理组织学及免疫组织化学检测结果后,与术后病理及免疫组织化学检查结果进行对比。结果:35例乳腺癌患者CNB组织免疫组织化学检测结果与手术切除组织的检测结果对比发现,PR、C-erbB-2和Ki-67表达程度差异无统计学意义(P均>0.05);ER表达程度差异有统计学意义,CNB组织表达的染色强度(数值)整体强于手术切除组织的检测结果(P<0.05),但在定性诊断上两种方法差异无统计学意义(P>0.05,Kappar值=0.8135)。结论:CNB标本免疫组织化学检测不仅可以准确反映乳腺癌肿瘤ER、PR、CerbB-2和Ki-67的定性表达,而且能准确反映乳腺癌PR、C-erbB-2和Ki-67的表达强度。但是,术前CNB标本ER表达强度整体强于术后切除标本,提示采用术前CNB标本检测ER和手术切除标本检测ER对比的方法评价术前化疗、内分泌治疗对乳腺癌ER表达的影响时,应考虑两者之间原本可能存在的差异。
Objective: To investigate the clinical value of preoperative nucleus needle aspiration biopsy (CNB) immunohistochemical detection of ER, PR, C-erbB-2, Ki-67 in the diagnosis of breast cancer. Methods: Thirty-five patients with breast cancer underwent partial resection of the tumor before surgery. The patient was given a core needle aspiration in the operating room before using the Bard gun to simulate the preoperative breast cancer CNB. The histopathology and immunohistochemistry After chemical test results, compared with postoperative pathology and immunohistochemistry results. Results: There was no significant difference in the expression of PR, C-erbB-2 and Ki-67 between the immunohistochemical results of CNB and the results of surgical resection in 35 breast cancer patients (all P> 0.05); ER (P> 0.05). However, there was no significant difference in qualitative diagnosis between the two methods (P> 0.05, P> 0.05). The expression intensity of CNB was significantly higher than that of the resected tissue Kappar value = 0.8135). Conclusion: Immunohistochemical detection of CNB specimens not only can accurately reflect the expression of ER, PR, CerbB-2 and Ki-67 in breast cancer, but also accurately reflect the expression of PR, C-erbB-2 and Ki-67 in breast cancer . However, the overall ER expression intensity of preoperative CNB specimens was significantly higher than that of resected specimens, which suggested that the preoperative evaluation of ER and surgical resection specimens by ER specimens and CNB specimens were used to evaluate the effect of preoperative chemotherapy and endocrine therapy on ER expression in breast cancer. Should consider the possible differences between the two.