The Expression Of Cytokeratin And Its Significance In Intraductal Proliferative Lesions Of Breast

Invasive breast carcinoma is the most common female malignant tumor, accounting for 22 percent of all female malignant tumors. It showed that breast intraductal proliferative lesions correlated with the risk of developing invasive breast carcinoma by clinical follow up. Breast intraductal proliferative lesions include UDH, ADH, DCIS and others. Many studies showed that the reproducibity of diagnosis of UDH, ADH and DCIS was poor. Some time it was very difficult for pathologist to diagnose these lesions merely depending on HE section. Now immunohistochemistry is a very useful method for pathologist to diagnose. The usual cytokeratins in differentiating breast intraductal proliferative lesions are CK5/6,CK34βE12 and CK8/18. The studies about expression patterns of these cytokeratins are fewer, and the results are different. After reviewing literatures, we have not found the reports about the expression pattern of CK19 in breast intraducal proliferatie lesions.In this study, immunohistochemistry staining was performed using CK19, CK8/18,CK5/6, CK34βE12 to investigate the rate, features and patterns of expression of cytokeratin 19, 8/18, 5/6 and 34βE12 in intraductal proliferative lesions of breast, and also to evaluate their role and significance in diagnosis and differential diagnosis of breast UDH, ADH, DCIS lesions. The results of this study are as follows:(1) The positive expression rate of CK19 in breast UDH, ADH and DCIS was 79.17%(19/24), 85.71%(12/14) and 95.83%(23/24), respectively. Among the 24 UDH cases, 18 cases are areataly positive for CK19, 1 case is diffusely-areataly positive. Among the 14 ADH cases, 10 cases are diffusely positive for CK19, 2 cases are areataly positive. Among the 24 DCIS cases, 22cases are diffusely positive for CK19, 1 case is areataly positive. Areataly positive expression is the main expression pattern in breast UDH, and diffusely positive expression is the main expression pattern in breast ADH and DCIS.(2) The positive expression rate of CK8/18 in breast UDH, ADH and DCIS was 83.33%(20/24),92.86%(13/14)and 95.83%(23/24), respectively. Among the 24 UDH cases, 9 cases are diffusely positive for CK8/18, 11 cases are areataly positive. Among the 14 ADH cases, 11 cases are diffusely positive for CK8/18, 1 case is diffusely- areataly positive, 1 case is areataly positive. Among the 24 DCIS cases, 23 cases are diffusely positive for CK8/18.(3) The positive expression rate of CK5/6 in breast UDH, ADH and DCIS was 91.67%(22/24),7.14%(1/14)and 4.17%(1/24), respectively. The positive expression rate of CK5/6 in UDH is significantly higher than that in ADH and DCIS﹙P<0.01). Among the 24 UDH cases, 15 cases are areataly positive for CK5/6, 4 cases are diffusely positive, 3 cases are diffusely-areataly positive. Among the 14 ADH cases, 1 case is areataly positive for CK5/6. Among the 24 DCIS cases, 1 case is diffusely positive.(4)The positive expression rate of CK34βE12 in UDH, ADH and DCIS was 87.50%(21/24),7.14%(1/14)and 4.17%(1/24), respectively. The positive expression rate of CK34βE12 in UDH is significantly higher than that in ADH and DCIS﹙P<0.01). Among the 24 UDH cases, 12 cases are areataly positive for CK34βE12, 7 cases are diffusely positive, 2 cases are diffusely-areataly positive. Among the 14 ADH cases, 1 case is areataly positive for CK34βE12. Among the 24 DCIS cases, 1 case is diffusely positive.The conclusions of this paper are as follows:(1)This study is first to conduct the expression pattern of CK19 in breastintraductal proliferative lesions, and reveal that its expression pattern is benefit to differentiate breast DCIS, ADH and UDH.(2)The expression rate of CK5/6 and CK34βE12 in breast ADH, DCIS and UDH is different, and the expression rate is helpful to the differential diagnosis in breast DCIS, ADH and UDH.This study is first to conduct the expression pattern of CK19 in breast intraductal proliferative lesions, and reveal that the expression pattern of CK19 is benefit to the differentiate breast DCIS, ADH and UDH. This study provides new way for the pathological diagnosis and differential diagnosis of breast intraductal proliferative lesions.