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ID 111180
タイトル別表記
日本における非浸潤性乳管癌の30%は極めて悪性度の低いcomedo壊死を有さないER陽性/HER2陰性タイプである
30% of Breast DCIS in Japan is low-grade
著者
兼松, 美幸 Shikoku Medical Center for Children and Adults KAKEN研究者をさがす
森本, 雅美 The University of Tokushima
Takahashi, Masako Tokushima Breast Care Clinic
本田, 純子 Higashi Tokushima Medical Center
Moriya, Takuya Kawasaki Medical School
田所, 由紀子 The University of Tokushima KAKEN研究者をさがす
中川, 美砂子 The University of Tokushima KAKEN研究者をさがす
武知, 浩和 The University of Tokushima KAKEN研究者をさがす
吉田, 卓弘 The University of Tokushima KAKEN研究者をさがす
Kajikawa, Aiichiro Shikoku Medical Center for Children and Adults
井本, 逸勢 The University of Tokushima KAKEN研究者をさがす
Sasa, Mitsunori Tokushima Breast Care Clinic
キーワード
Low grade DCIS
Ki67 index
ER positive and HER2 negative
comedo-necrosis
mammography
資料タイプ
学位論文
抄録
Background Overdiagnosis in mammography (MMG) is a problem. Combination of MMG and ultrasonography for breast cancer screening may increase overdiagnosis. Most cases of overdiagnosis are low-grade ductal carcinoma in situ (LGD), but no reports have focused on them. Materials and methods We immunostained 169 ductal carcinoma in situ (DCIS) cases for ER, PgR, HER2 and Ki67 and classified them into 4 subtypes : ER(+)/ HER2(-), ER(+)/HER2(+), ER(-)/HER2(-) and ER(-)/HER2(+). The Ki67 index was used to evaluate the grade of malignancy and examined for correlations with each ER/HER2 subtype and the nuclear grade (NG), with/without comedo necrosis. Results The Ki67 index correlated significantly with NG, both with/without comedo necrosis, and reliably evaluated the grade of malignancy. The index for ER(+)/HER2(-) (n=117, 69.2%) was 7.45±7.10, which was significantly lower than for each of the other types. The index was 5.71±6.94 for ER(+)/HER2(-) without comedo necrosis (n=52, 30.8%), which was significantly lower than with comedo necrosis. This was considered LGD, characterized by absence of microcalcification in MMG and either presence of a solid mass or cystic lesion or absence of hypoechoic areas in ultrasound. Conclusion In Japan, ER(+)/HER2(-) without comedo necrosis accounts for about 30% of DCIS and is LGD. This may be being overdiagnosed.
掲載誌名
The Journal of Medical Investigation
ISSN
13496867
13431420
cat書誌ID
AA11166929
AA12022913
出版者
Faculty of Medicine Tokushima University
63
3-4
開始ページ
192
終了ページ
198
並び順
192
発行日
2016-08
備考
内容要旨・審査要旨・論文本文の公開
本論文は,著者Miyuki Kanematsuの学位論文として提出され,学位審査・授与の対象となっている。
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
博士論文全文を含む
文科省報告番号
乙第2120号
学位記番号
乙医第1763号
学位授与年月日
2022-03-16
学位名
博士(医学)
学位授与機関
徳島大学
部局
病院
医学系