The Expression And Clinical Significance Of P63, P504S And Ki67 In Breast Benign And Malignant Lesions

Objective: To detect jointly the expression of tumor anti-ogenencogenep63, prolifecative antigen Ki67 and branched-chainβoxidation fatty acidsP504S in breast benign and malignant lesions and investigate the evaluationof their actual application so as to provide molecular biological markers forearly diagnosis of breast carcinoma and for estimate of prognosis diagnosisand differential diagnosis.Materials & Methods: Totally 54 cases of paraffin-embedded tissuespecimen of breast benign and malignant lesions were chosen out of thepathology files from the year of 2004 to 2006 made by the PathologyDepartment in Affiliated Hospital of Medical College, Yanbian University.Among which, 10 cases of benign breast lesions (with breast fibroadenoma 2cases, breast proliferative lesions 3 cases, intraductal papilloma ofgalactophore 3 cases and sclerosing adenosis 2 cases) and 44 cases ofmalignant breast lesions (with ductal carcinoma in situ 10 cases, breastinfiltrative ductal carcinoma 15 cases, invasive lobular carcinoma of the breast 10 cases, breast lobular carcinoma in situ 5 cases and mucinousadenocarcinoma 4 cases) were included respectively and were all 10%formalin-fixed, paraffin-embedded, HE dyeing and free from anypathological diagnosis objection. SP methods of immunohistochemicaiassays was applied in detecting the expression of p63,P504S,Ki67 inabove diseases.Results: 1)p63 is expressed in benign breast lesions. MEC from 10 casesof benign breast lesions indicated sensitively that myoepithelial cells exists.myoepithelial p63 dyeing positive, acinar cell and ducts surrounded bycontinuous myo-epithelium with 100% positive rate. Carcinoma in situ(ductal carcinoma in situ 10 cases and breast lobular carcinoma in situ 5cases) was observed with myo-epithelium cells around carcinoma decreasingin number and distributed intermittently, p63 dyeing expresseddiscontinuously, p63 negative where invasive carcinoma occurs showingdisappearance of myo-epithelium cells. As for 15 cases of infiltrative ductalcarcinoma and 10 cases of invasive lobular carcinoma, p63 dyeing remainsnegative, but p63 is not expressed in gland-epithelial cells as well as stromaltumors and gland- epithelium etc. Around invasive carcinoma disappearmost of the myoepithelial cells or even witness no distribution ofmyoepithelial cells. Positive rate of 34.1% is shown in carcinoma tissues.2) The expression of Ki67 is not observed in the 10 cases of benign breastlesions. Positive rate 77.2% is shown for Ki67 in carcinoma tissues.Between benign breast lesions and carcinoma tissues, distinctiveness P＜0.01remains in positive rate. 3) As for 44 cases of breast carcinoma tissues,P504S positive i Ki67 s observed in 29 cases taking up 65.9% of all cases including(+++) 18 cases (40.9%), (++) 6 cases (13.6%) and (+) 5cases (11.4%). 10 cases of benign breast lesions(breast proliferative lesions3 cases, sclerosing adenosis 2 cases, fibroadenoma 2 cases and intraductaipapilloma of galactophore 3 cases) witness P504S negative. 10 cases ofductal carcinoma in situ and 15 cases of breast infiltrative ductal carcinomawitness P504S dyeing positive for visiable carcinoma cells. 5 cases of breastlobular carcinoma in situ and 10 cases of invasive lobular carcinoma witnessP504S negative. 4)In benign breast lesions, p63 shows 100% positive ratewhile P504S and Ki67 remain negative.Conclusion: 1) In the case of p63 protein, the expression strength ishigher in benign tumors and lowest in malignant tumors, and the resultsappear stable and reliable, p63 protein witnesses higher specility andsensitivity which facilitates the display of the basic structure of breastacinars and ducts objectively so as to put good accessorial affect ondiagnosis of breast lesions. 2) In the case of P504S, although dyeing doesn'thelp much for identification of invasive ductal carcinoma and benign breasthyperplasia, it facilitates the clear identification of lobular and ductcarcinoma appeared unclear under some light microscopes. 3) It is observedin this test that the expression of Ki67 is higher compared to benign breastlesions no matter what the degree of differentiation of breast carcinoma is.which indicates that breast cancer is under high proliferative condition andthus states in certain degree that Ki67 detection can serve as an ancillarydiagnosis method for identification of breast benign and malignant lesions.