乳腺癌术前巴德枪穿刺检测ER、PR的临床研究(1)
摘 要：目的 探讨乳腺癌术前巴德枪穿刺活检检测 ER、PR在乳腺癌治疗中的临床应用价值。方法 选取山东省济南市市中区人民医院外科2013年12月～2015年12月36例乳腺癌患者，术前采用巴德枪穿刺获得病理组织，并进行免疫组织化学检测，与术后常规病理免疫组织化学检测结果进行对比。结果 36例乳腺癌患者术前巴德枪穿刺病理组织行免疫组织化学检测结果与术后常规病理检测结果对比发现，ER表达程度差异无统计学意义(P>0.05)；PR表达程度差异有统计学意义(P<0.05)。结论 术前巴德枪穿刺获得的组织经免疫组织化学检测可以反映乳腺癌ER、PR的表达以及表达强度，但是PR表达强度却高于术后常规免疫组织化学检测结果，提示采用术前巴德枪穿刺组织检测的PR作为评估内分泌治疗对乳腺癌PR表达的影响时，应考虑与术后常规免疫组织化学检测结果的差异。
关键词：巴德枪；穿刺活检；乳腺癌；雌激素受体；孕激素受体
中图分类号：R737 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.050
, http://www.100md.com
文章编号：1006-1959(2018)13-0163-03
Abstract：Objective To investigate the clinical value of ER and PR in the treatment of breast cancer with preoperative Bard gun biopsy.Methods 36 patients with breast cancer were enrolled in the Department of Surgery，Shizhong District People's Hospital，Jinan City，Shandong Province from December 2013 to December 2015.The pathological tissues were obtained by Bard gun puncture before operation，and immunohistochemical examination was performed.The results were compared with the results of routine pathological immunohistochemistry.Results The immunohistochemical results of preoperative Bard gun puncture pathology in 36 patients with breast cancer were compared with the results of routine pathological examination. The difference of ER expression was not statistically significant(P>0.05).The difference of PR expression was statistically significant (P<0.05).Conclusion The tissue obtained by Bard gun puncture before operation can reflect the expression of ER and PR and the expression intensity of breast cancer，but the intensity of PR expression is higher than that of routine immunohistochemistry after surgery，suggesting the use of preoperative Bard gun.When PR is detected by puncture tissue as an assessment of the effect of endocrine therapy on PR expression in breast cancer，differences from postoperative routine immunohistochemistry results should be considered.
, 百拇医药
Key words：Bard gun；Puncture biopsy；Breast cancer；Estrogen receptor；Progesterone receptor
乳腺癌(breast cancer)作为女性最常见的癌症之一，其发病率呈逐年上升趋势。据文献报道乳腺癌发病率在女性惡性肿瘤中已上升至第1位，且发病年龄越来越年轻化[1]。对于乳腺癌，手术已不再是唯一的治疗手段。近年来治疗乳腺癌的新辅助化疗、生物治疗以及内分泌治疗等都得到了广泛应用，其中内分泌治疗即激素抑制治疗，已成为治疗乳腺癌不可缺少的重要手段之一。在临床上医师主要是通过检测乳腺癌细胞中雌激素受体(ER)和孕激素受体(PR)来决定是否采用内分泌治疗手段。对于乳腺癌术前的免疫组化检测，临床上大多依赖核芯针穿刺活检[2](CNB)，其中巴德枪(Bard枪)是现阶段最为出色的穿刺设备，可以保证操作的安全性和取材的准确性[3]。文献报道乳腺癌术前内分泌治疗和新辅助化疗对ER、PR等生物学指标会产生一定的影响[4]。但对于术前巴德枪穿刺获取的免疫组化检测与术后常规病理结果之间是否存在统计学差异，即术前巴德枪穿刺获得的ER、PR测定结果能否完全代替常规手术后获得的免疫组织化学测定结果，依旧存在不少争议[5]。本研究收集了2013年12月～2015年12月36例诊断为乳腺癌的患者，术前巴德枪穿刺获得的ER、PR免疫组化指标，与手术后获得的免疫组织化学结果进行比较， 探讨两者的一致性。, http://www.100md.com(杨玉峰 李强 曲国红 孔哲 赵呈祥)
关键词：巴德枪；穿刺活检；乳腺癌；雌激素受体；孕激素受体
中图分类号：R737 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.13.050
, http://www.100md.com
文章编号：1006-1959(2018)13-0163-03
Abstract：Objective To investigate the clinical value of ER and PR in the treatment of breast cancer with preoperative Bard gun biopsy.Methods 36 patients with breast cancer were enrolled in the Department of Surgery，Shizhong District People's Hospital，Jinan City，Shandong Province from December 2013 to December 2015.The pathological tissues were obtained by Bard gun puncture before operation，and immunohistochemical examination was performed.The results were compared with the results of routine pathological immunohistochemistry.Results The immunohistochemical results of preoperative Bard gun puncture pathology in 36 patients with breast cancer were compared with the results of routine pathological examination. The difference of ER expression was not statistically significant(P>0.05).The difference of PR expression was statistically significant (P<0.05).Conclusion The tissue obtained by Bard gun puncture before operation can reflect the expression of ER and PR and the expression intensity of breast cancer，but the intensity of PR expression is higher than that of routine immunohistochemistry after surgery，suggesting the use of preoperative Bard gun.When PR is detected by puncture tissue as an assessment of the effect of endocrine therapy on PR expression in breast cancer，differences from postoperative routine immunohistochemistry results should be considered.
, 百拇医药
Key words：Bard gun；Puncture biopsy；Breast cancer；Estrogen receptor；Progesterone receptor
乳腺癌(breast cancer)作为女性最常见的癌症之一，其发病率呈逐年上升趋势。据文献报道乳腺癌发病率在女性惡性肿瘤中已上升至第1位，且发病年龄越来越年轻化[1]。对于乳腺癌，手术已不再是唯一的治疗手段。近年来治疗乳腺癌的新辅助化疗、生物治疗以及内分泌治疗等都得到了广泛应用，其中内分泌治疗即激素抑制治疗，已成为治疗乳腺癌不可缺少的重要手段之一。在临床上医师主要是通过检测乳腺癌细胞中雌激素受体(ER)和孕激素受体(PR)来决定是否采用内分泌治疗手段。对于乳腺癌术前的免疫组化检测，临床上大多依赖核芯针穿刺活检[2](CNB)，其中巴德枪(Bard枪)是现阶段最为出色的穿刺设备，可以保证操作的安全性和取材的准确性[3]。文献报道乳腺癌术前内分泌治疗和新辅助化疗对ER、PR等生物学指标会产生一定的影响[4]。但对于术前巴德枪穿刺获取的免疫组化检测与术后常规病理结果之间是否存在统计学差异，即术前巴德枪穿刺获得的ER、PR测定结果能否完全代替常规手术后获得的免疫组织化学测定结果，依旧存在不少争议[5]。本研究收集了2013年12月～2015年12月36例诊断为乳腺癌的患者，术前巴德枪穿刺获得的ER、PR免疫组化指标，与手术后获得的免疫组织化学结果进行比较， 探讨两者的一致性。, http://www.100md.com(杨玉峰 李强 曲国红 孔哲 赵呈祥)