Імуногістохімічні маркери P63 та a-SMA в діагностиці неінвазивного протокового рака молочної залози

Abstract

Мета даного дослідження - пошук морфологічних критеріїв виключення інвазивного росту протокового раку молочної залози. Встановлено, що маркером цілісності стінки канцеризованої протоки молочної залози може слугувати базальнорозташований епітелій, експресуючий маркери a-sma та р63 у разі його безперервного розташування. Шар клітин, що вистеляють міжчасточкову протоку залози складається з мікроворсинчастого, резервного та міоєпітелію; Цель данного исследования - поиск морфологических критериев исключения инвазивного роста внутрипротокового рака молочной железы. Установлено, что маркером целостности стенки канцери- зированого протока молочной железы может служить базальнорасположеный епителий, который експрес- сирует иммуногистохимические маркеры a-sma и р63 при условии его беспрерывного расположения. Слой клеток, выстелающий междольковий проток молочной железы, состоит из микроворсинчатого, резервного и миоэпителия; Objective. To search and compare peculiarities of duct lining cellular composition of both healthy mammary gland duct and pathomorphologycal diagnosed non-invasive ductal carcinoma. Results. There is high level of morbidity associated with mammary gland cancer among women in the world. In addition, in Ukraine there is a tendency to the elevation of death rate among women (up to 60 the occurrence of cancer per 100 thousandths of female population) caused by the neaplasia which, in its turn, is connected with late diagnostics and compications of the tumor invasive grow. Investigation of mammary duct cell composition in case of both norma and tumor of mammary gland is realized on the histologic specimen from the Poltava regional pathology anatomy department archives. All the material was examined by means of histochemical (hematoxylin-eosin-stained sections) and immunohistochemical (immunohistochemical staining with р63 and a-sma) methods, histological samples were prepared from certain preparations. Photographies of histological slides were taken with digital camera and microscope «Olympus» company. The following variants of the normal mammary gland duct epithelium were found in the women of 20 - 40 yeas old: myoepithelium, reserve and microvillous epithelium. Mathematical investigation has showed rhythmical cells growth in form of cell nucleus LgV 0,55; 0,75; 0,9. Myoepithelium is characterized with continuous basal disposition as well as p63 and a-sma expression. Reserve epithelium is located in parabasal region of the mammary gland duct and expresses p63. Microvillous epithelium doesn’t express p63 and a-sma, it characterizes with microvillous structures on it apical surface. Integrated study of pseudopapillary intraductal carcinoma has revealed disturbance in intermittent cells growth in form of cell nucleus LgV 0,55; 0,9; 1,05; 1,45. For the tumor version among the variants of malignant duct epithelium cells expresses features of derivative epithelium are found. Thouse are microvillous cells and myoepithelium shows p63 and a-sma expression. Last ones noncontinuous located in contrast to their normal analog. On our opinion, these factors play important role in following tumor invasive growth. Conclusions. Thus, moderm complex morphological investigation of both epithelial lining of mammary gland duct and its hystogenetic neoplastic equivalent - pseudopapillary form of ductal mammary gland carcinoma permits us to do following conclusions: Epithelial layer of interlobular mammary gland ductules consists of three kinds of cells. Those are microvillous cells, reserve epithelium and basal situated myoepithelium. It is possible to use immunohistochemical markers p63 and a-sma in presses of mammary gland cancer invasive growth exclusion provided that marked cells compose uninterrupted epithelial layer. Prospects for further research. To explore absence invasive tumor growing characters in other morphological alternate version of ductal mammary gland carcinoma.