| Background and objective: Invasive lobular carcinoma and Invasive ductal carcinoma of no special type are sometimes indistinguishable in conventional paraffin sections and require immunohistochemical staining for further diagnosis.Because of their different biological behaviors,surgical methods and clinical outcomes,it is particularly important to diagnose invasive lobular carcinoma and Invasive ductal carcinoma of no special typemore accurately.Detection of E-cad、 p120 and β-catenin in invasive lobular carcinoma and Invasive ductal carcinoma of no special typeof the expression,and compared its expression in normal breast tissue,contrast analysis of E-cad,p120 and β-catenin expression in breast cancer and the correlation between histological type and clinical pathologic features;To investigate whether the combined application of Ecadherin,p120 and β-catenin can improve the accuracy of differentiating Invasive ductal carcinoma of no special typefrom invasive lobular carcinoma;The ultimate goal is to provide individualized and precise treatment for patients and improve their quality of life.Materials and methods: The basic clinical information of all eligible breast cancer patients was obtained from the electronic database of clinical pathology department of yijishan hospital,wannan medical college.select the time range is January 1,2011 to October 1,2019,the histopathological types were invasive lobular carcinoma and Invasive carcinoma(non-specific type),The surgical methods were all radical mastectomy,and collect the details of the clinical pathological data,including age,gender,primary tumor size(T),presence of neural、vascular invasion,etc;Among them,the number of effective screening cases for invasive lobular carcinoma was 44,and the number of eligible cases for Invasive ductal carcinoma of no special typewas also randomly screened in 44,and 10 normal breast tissues and adjacent tissues(4cm away from the tumor)were selected as the control group.2.The results of routine paraffin sections and immunohistochemical staining of E-cadherin,p120 and β-catenin in 44 cases of invasive lobular carcinoma and 44 cases of Invasive ductal carcinoma of no special typewere re-evaluated,and the expression differences of E-cadherin,p120 and β-catenin in Invasive ductal carcinoma of no special typeand invasive lobular carcinoma were discussed and recorded.3 cases,pick out the screening of effective organization wax block,using tissue microarray technology made into tissue chip,using E-cadherin,p120 and β-catenin antibody immunohistochemical staining,as far as possible eliminate possible difference(such as the thickness of slice,reagent dosage,time,temperature,etc.),the expression of E-cadherin,p120 andβ-catenin in the tissue was detected。Due to the dispatination of the tissue chip,secondary screening was conducted to compare the expression of E-cadherin,p120 and β-catenin in normal breast tissue、Invasive ductal carcinoma of no special typeand invasive lobular carcinoma.To analyze the correlation of E-cadherin,p120 and β-catenin expression and its relationship with histopathological type and clinical characteristics.To investigate the correlation between the clinicopathological features,histological types and prognosis of ILC and IDC-NSTs.4.SPSS 23.0 software was used for statistical analysis,2 test and paired chi-square test were used for statistical analysis of the collected data to study the histological type,clinicopathological characteristics and the correlation with the expression of p120,Ecadherin and β-catenin in patients with Invasive ductal carcinoma of no special typeand invasive lobular carcinoma.Test level a=0.05,and the difference was statistically significant when P < 0.05 was calculated.Results: IDC-NSTs cancer cells are large in size,rich in cytoplasm,and have obvious atypia.The histology can often be arranged into cords,clusters,trabeculae,nests,or solid arrangement.Occasionally,areas with single-layer linear infiltration or target annular arrangement can be seen,similar to invasive lobular carcinoma,but lacking the morphological characteristics of lobular cancer cells.Except for a few variant types,most ILC cancer cells are relatively small,have the same shape and lack adhesion.The cancer cells invasive the interstitium in single or single line,presenting a private or target circular arrangement.There are also many variations in cell morphology: sigmoid,plasma cell,muscle,tissue cell and pleomorphic changes.Although the pleomorphic infiltrating lobular carcinoma also shows single and linear infiltrating interstitium,the cells are larger than the typical ILC,the nuclear pleomorphism is significant,and the cytogenetic characteristics are more like IDC-NSTs.The expression of E-cadherin in all Invasive ductal carcinoma of no special typeand normal breast tissues showed complete membrane positive in 54 cases(100%),cytoplasmic positive in 0 cases(0%),and expression deficiency in 0 cases(0%).There were 54 cases(100%)with positive p120 expression membrane,0 cases(0%)with positive cytoplasm,and 0 cases(0%)without expression.There were 54 cases(100%)with positive expression membrane of β-catenin,0 cases(0%)with positive cytoplasm,and 0 cases(0%)with expression deletion.In the invasive lobular carcinoma,there were 1 case(2.27%)with positive E-cadherin expression membrane,8 cases(18.18%)with positive cytoplasm,and 35 cases(79.55%)with no expression.There were 0 cases(0%)with positive p120 expression membrane,41 cases(93.18%)with positive cytoplasm,and 2 cases(6.82%)with deficient expression.There were 1 case(2.27%)with positive expression membrane of β-catenin,3 cases(6.82%)with positive cytoplasm,and 40 cases(90.91%)with missing expression.Invasive carcinoma(non-specific type),normal breast tissue and invasive lobular carcinoma had no correlation with the age of the patients and the size of the primary tumor,and the difference was not statistically significant(P=0.496 and 0.127),However,There was significant difference between whether nerve invasion and whether cancer embolism(P=0.049 and 0.007).The cell membrane positive expression rates of E-cadherin and β-catenin in normal breast tissues,IDC-NSTs and ILC were 100%,100% and 2.27%,with no significant difference in expression rates(P=1.00).The expression rates of E-cadherin,p120 and β-catenin in invasive lobular carcinoma and Invasive ductal carcinoma of no special typewere significantly different(P=0.01,0.01 and 0.01).The expression rate of p120 in invasive lobular carcinoma was not statistically significantly different from that of E-cadherin and β-catenin(P=0.661 and 0.851),but there was statistically significant difference between E-cadherin and β-catenin in invasive lobular carcinoma(P=0.001).There was no statistically significant difference in the expression rates of E-cadherin,p120 and β-catenin with the age of the patients(P=0.756,0.245 and 0.161).There were no statistically significant differences in the expression rates of E-cadherin,p120 and β-catenin with the size of the primary tumor(P=0.434,0.605 and 0.510).There was no statistically significant difference in the expression rates of Ecadherin,p120 and β-catenin in ILC with whether nerve invasion(P=0.100,0.784 and 0.950).There was a correlation between the presence or absence of cancer embolism in the vein and the expression of β-catenin in ILC,with a statistically significant difference(P=0.046),but no statistically significant difference with the expression rates of p120 and E-cadherin(P=0.695 and 0.486).Conclusions: 1.Different expression patterns of e-cadherin,p120 and catenin in IDC-NSTs and ILC have high application value in differential diagnosis,while age,primary tumor size,nerve invasion and vascular invasion have little effect. |
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