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目的:在乳腺癌诊治技术的新发展下，分析癌组织中细胞核形态与不同临床病理特征的关系，并评估其临床应用意义。方法:在TCGA(The Cancer Genome Atlas)数据库的BRCA(Breast Invasive Carcinoma)数据中，将443例患者根据细胞核形态大小将样本分为三组：⑴细胞核大小形态基本正常；⑵细胞核大小稍微增加；⑶细胞核大小稍微增加或差异明显。比较三组美国癌症联合委员会(AJCC)临床病理分期、免疫组化雌激素受体(ER)、孕酮受体(PR)和人类表皮生长因子受体2(HER2)结果以及PAM50分子分型等临床病理指标。结果:乳腺癌组织中细胞核大小与患者生存期，尤其是无病生存期显著相关(n P＝0.039)。其余的临床病理指标，除了AJCC T分期(n P＝0.006)、分子标记物ER(n P＝0.002)和PR(n P＝0.047)的免疫组化结果以及PAM50分子分型(n P<0.001)外，未发现与癌组织细胞核大小有明显关联关系。面积、周长、圆度、长和宽等在内的细胞核形态计量参数相互关联；其中圆度参数最为稳定，与其他参数呈负相关，其中周长作为鉴别指标最为灵敏，而圆度不灵敏。n 结论:乳腺癌组织中细胞核大小与乳腺癌分子标记物ER和PR的免疫组化结果显著相关；与圆度相比，细胞核周长具有更大的ROC曲线下面积，临床应用价值更大。“,”Objective:Under the new development of breast cancer diagnosis and treatment technology, the relationship between nuclear morphology and different clinicopathological characteristics of breast cancer was analyzed, and its clinical significance was evaluated.Methods:In TCGA (the Cancer Genome Atlas) BRCA (fast invasive carcinoma) data, 443 patients were divided into three groups according to the nuclear morphology: ⑴ the nuclear size and morphology were basically normal; ⑵ the nuclear size slightly increased; ⑶ the nuclear size slightly increased or the difference was obvious. Practical clinicopathological features including American Joint Committee on Cancer (AJCC) tumor stage, AJCC tumor score, AJCC lymph node score, estrogen receptor (ER) status by immunohistochemistry (IHC), progesterone receptor (PR) status by IHC, human epidermal growth factor receptor 2 (HER2) status by IHC and PAM50 subtypes are compared among groups defined by nuclear size. And nuclear size related morphometric parameters, including nuclear area, perimeter, roundness, width and height, are subsequently retrieved in 132 samples and analyzed for their relationship with clinicopathological features.Results:The nuclear size in breast cancer tissues was significantly correlated with survival, especially disease-free survival (n P=0.039). Other clinicopathological parameters, except AJCC T stage (n P=0.006), the immunohistochemical results of molecular markers ER (n P=0.002), PR (n P=0.047) and molecular typing of PAM50 (n P<0.001) were not significantly associated with the nuclear size of cancer tissues. The area, perimeter, roundness, length and width were correlated with each other; the roundness was the most stable parameter and negatively correlated with other parameters; the perimeter was the most sensitive index for identification, while roundness was not.n Conclusions:Our research indicates that nuclear size, especially nuclear morphometric parameter, perimeter, provides a valuable clinicopathological index, which is useful not only in differentiating breast cancer cells from normal cells, but in differentiating molecular subtypes.