유방 관상피증식성 병변과 관암종 감별에 있어서의고분자양 CK와 CK5/6 면역염색의 유용성 = The Utility of HMW-CK and CK5/6 ImmunohistochemicalStains for Differentiating Ductal Proliferative Lesions andDucal Carcinoma of the Breast

다국어 초록 (Multilingual Abstract)

Background : Basal-type cytokeratins may help to distinguish benign from malignant intraductal
proliferative lesions. The basal-type cytokeratins expression is markedly decreased or
absent in atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and invasive ductal
carcinomas (IDC). However, the expression patterns vary according to the antibodies that
are used for staining. Methods : HMW-CK (clone 34 E12) was applied to 175 lesions, and
CK5/6 (clone D5/16B4) was applied to 145 lesions. The specimens were IDC (n=165), DCIS
(n=35), ADH (n=37), florid ductal hyperplasia (FDH) (n=38) and columnar cell lesion (CCL)
(n=45). The expression patterns of HMW-CK and CK5/6 were categorized as negative, focal
positive and positive. Results : Loss of the HMW-CK expression was noted in 76% (66/87) of
the IDC, 78% (21/27) of the DCIS, 78% (21/28) of the ADH, and 55% (10/18) of the FDH. Loss
of the CK5/6 expression was found in 96% (75/78) of the IDC, in all the DCIS (n=8) and ADH
(n=9), and in none of the FDH (n=20). Loss of the CK5/6 expression is more reliable than that
of the HMW-CK expression for differentiating FDH, ADH and malignant intraductal proliferatve
lesions. Eleven (73%) of 15 CCLs revealed the loss of the HMW-CK expression, but all
the CCLs (n=30) were negative for CK5/6 (p=0.0161). Conclusion : CK5/6 antibody is more
reliable than HMW-CK antibody for differentiating FDH from ADH or DCIS, and for discriminating
CCL.

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