The Clinical Pathology Study Of The Basal-like Breast Carcinoma

Breast carcinoma is one of the most common malignancy in females, and about4million women die of the disease each year in the world. Usually it is considered that breast carcinoma originated in the breast terminal duct cancer-lobular unit and expressed glandular epithelial immune markers. But in recent years there have been reported continuously that a part of breast carcinoma also expressed myoepithelial-type immune markers, and the prognosis is worse than the average of invasive breast cancer. With in-depth study of molecular biology, breast cancer that expressed myoepithelial-type immune markers can be identified and named as basal-like breast carcinoma based on gene expression profiling. Studies have shown that the BLBC accounts for approximately8%～20%of breast carcinomas and it accounts for25%of high-level breast cancer.lt is also reported that BLBC has the highest proliferation index and adverse clinical outcomes compared with other genotyping of breast cancer. So more and more clinicians and researchers begin to pay attention to it.The first part The morphological tissue characteristics of basal-like breast carcinomaObjective:To inverstigate the morphological tissue characteristics, immunophenotype and explore the prognosis of basal-like breast carcinoma.Methods: Selecting three hundred and twenty five cases of invasive ductal carcinomas, immunohistochemistry method was used to determine the expression of ER、 PR、HER-2、CK5/6、p63and EGFR, then selecting BLBC cases with ER、 PR、HER-2negative, CK5/6and/or P63and/or EGFR positive as well as non-BLBC cases with ER、PR and/or HER-2positive cases. Summarize the clinical data of two groups of cases, making HE sliced and observing its morphological tissue characteristics. The data were analyzed by using SPSS16.0for windows.Results:1. Selected51cases of BLBC and50cases of non-BLBC, all the patients were females.2. The comparison results of BLBC group and non-BLBC group on the aspects of onset ages,neoplasm distribution in both sides of the mammary gland, tumor size and histologic classification show that the comparison has not statistical significance (P≥0.05), but BLBC group has younger trend and higher level histologic classification compares to non-BLBC group.3. The comparison of morphological tissue characteristics has statistical significance (P<0.05).The tumors showed solid architecture with no tubule formation and a high density of tumor cells with scant intervening stroma between tumor cells. The majority of tumors showed a pushing growth pattern and had some degree of a stromal lymphocytic infiltrate at the tumor edge. The tumor cells were arranged in solid nests, sheets, cords and regions of ribbon-like architecture with associated central geographic necrosis and showed a central acellular fibrotic zone. The tumor cells contained scant cytoplasm and round to oval nuclei producing a high nuclear/cytoplasmic ratio and showed syncytial growth. A high mitotic rate was identified in all tumors (14～35/10HPF).4. The recurrence rate of BLBC group higher than that of non-BLBC group and the disease-free surial of BLBC group belower than that of non-BLBC group.Conclusions:BLBC is a new subtype of breast carcinoma with unique immunophenotype, distinctivemor phological features and prognosis Conventional light microscopy usually permits a correct diagnosis. The second part The expression of CD109、CD117、Vimentin、P53、 ki-67in basal-like breast carcinoma and Clinical valueObjective:To detect the expression of CD109、CD117、Vimentin、P53、ki-67and their significances in basal-like breast carcinoma(BLBC).Methods:Detecting the expression of CD109、CD117、Vimentin、P53and ki-67in51cases of BLBC and50cases of non-BLBC with immunohistochemistry method, then analysing the correlation with BLBC and looking for a potential molecular cancer therapeutics. The data were analyzed by using SPSS16.0for windows.Results:The positive rates of CD109、CD117、Vimentin、P53、ki-67expression were60.78%(31/51)、11.76%(6/51)、50.98%(26/51)、84.31%(43/51)、66.67%(34/51) and0(0/50)、4%(2/50)、34%(17/50)、42.%(21/50)、44%(22/50) in BLBCs and Non-BLBCs respectively. The positive rates of CD109、P53、 ki-67were respectively, the significant difference were found(P<0.05) between BLBCs and Non-BLBCs. The expression of P53、ki-67in BLBCs was much higher than that of Non-BLBCs. The expression of CD117、 Vimentin in BLBCs was lower than that of Non-BLBCs.conclusions:These findings indicate that CD109is a useful diagnostic marker for BLBC and that CD109expression may affect biological properties of cancer cells as a new potential therapeutic target.CD117、Vimentin is not the useful diagnostic markers. P53、ki-67play an important role in development of BLBC.