摘要目的：探讨乳腺浸润性导管癌中碳酸酐酶Ⅸ蛋白表达与纤维灶之间的关系。方法采用免疫组织化学MaxVision法检测167例乳腺浸润性导管癌中雌激素受体（ ER ）、孕激素受体（PR）、碳酸酐酶Ⅸ的表达，同时镜下观察纤维灶。结果（1）乳腺癌伴纤维灶（45／80，56．3％）病例癌细胞碳酸酐酶Ⅸ阳性率明显高于乳腺癌不伴纤维灶（25／87，28．7％），差异有统计学意义（P＝0．001）；乳腺癌伴纤维灶病例中，纤维母细胞碳酸酐酶Ⅸ阳性组（35／40，87．5％）癌细胞碳酸酐酶Ⅸ的表达率明显高于阴性组（10／40，25．0％），二者差异有统计学意义（P＜0．001）。（2）乳腺癌伴纤维灶病例中组织学3级病例（23／33，69．7％）的纤维母细胞碳酸酐酶Ⅸ阳性率明显高于（1＋2）级（17／47，36．2％），二者差异有统计学意义（P＝0．006）；纤维母细胞碳酸酐酶Ⅸ阴性组内，ER和PR的阳性率分别为72．5％（29／40）和65．0％（26／40），纤维母细胞碳酸酐酶Ⅸ阳性组中，ER和PR的阳性率分别为50．0％（20／40）和42．5％（17／40），纤维母细胞碳酸酐酶Ⅸ阴性组激素受体的阳性率均明显高于阳性组，二者差异有统计学意义（ P＝0．04）；纤维母细胞碳酸酐酶Ⅸ阴性组的患者年龄明显高于阳性组，二者差异有统计学意义（ P＝0．002）。纤维母细胞碳酸酐酶Ⅸ阳性组的纤维灶／肿瘤直径比明显大于阴性组，二者差异有统计学意义（P＝0．024）。（3）肿瘤最大径≤2 cm组、2 cm＜肿瘤最大径≤5 cm组的纤维灶直径均小于肿瘤最大径＞5 cm组，差异均有统计学意义（ P＜0．01）。结论碳酸酐酶Ⅸ的表达与纤维灶有关，纤维灶中的纤维母细胞表达碳酸酐酶Ⅸ还与患者年龄、肿瘤细胞组织学分级、激素受体表达和纤维灶直径／肿瘤直径有关，提示纤维母细胞表达碳酸酐酶Ⅸ可能是乳腺癌预后较差的标志。

abstractsObjective To study the relationship between fibrotic focus ( FF ) and carbonic anhydrase ( CA) Ⅸin invasive ductal carcinomas ( IDC) of the breast.Methods In 167 cases of IDC, the FF was assessed morphologically, and expression of ER, PR and CA Ⅸ was evaluated using MaxVision immunohistochemistry.Results The expression of CAⅨin IDC with and without FF was 56.3%(45/80) and 28.7%(25/87) respectively, with significant difference (P=0.001).In IDC with FF, the CA Ⅸexpression of tumor cells in tumors with CAⅨ-positive fibroblasts (35/40, 87.5%) was significantly (P<0.001) higher than that in tumors with CAⅨ-negative fibroblasts (10/40, 25.0%).In IDC with FF, the CAⅨexpression of fibroblasts of FF in grade 3 IDC ( 23/33, 69.7%) was significantly ( P =0.006 ) higher than that in grade 1 +2 tumors (17/47, 36.2%).The ER and PR expression of tumor cells in tumors containing CA Ⅸ-negative fibroblasts was 72.5% ( 29/40 ) and 65.0% ( 26/40 ) respectively, whereas the ER and PR expression of tumor cells in tumors containing CAⅨ-positive fibroblasts was 50.0%(20/40) and 42.5% (17/40) respectively; the difference was statistically significant (for both ER and PR, P=0.04 ) .The age of patients with tumors containing CA Ⅸ-negative fibroblasts was significantly ( P=0.002) older than those containing CA Ⅸ-positive fibroblasts.The FF diameter/tumor diameter in&nbsp;tumors containing CA Ⅸ-positive fibroblasts was significantly larger than those containing CA Ⅸ-negative fibroblasts.(3) For the groups of tumor size≤2 cm and tumor size between 2 cm to 5 cm, the diameter of the fibrotic focus was significantly (P<0.01) smaller than the fibrotic focus size of tumors >5 cm in size. Conclusions CA IX expression is correlated with FF, and that in fibroblasts of FF correlated with patients′age, tumor grade, hormone receptors and FF diameter/tumor diameter.CAⅨexpression in FF might be a marker for poor prognosis in patients with breast cancer.