摘要
目的探讨乳腺浸润性微乳头状癌(IMPC)的临床病理特征、免疫组化表达,并结合文献探讨其预后。方法对30例IMPC及39例浸润性导管癌(IDC)标本行组织病理和免疫组化检测,观察其组织形态改变、分析病理特征。结果 30例IMPC镜下特征性表现为肿瘤细胞呈桑椹状、微乳头状或小腺管样,癌巢与周围间质形成明显间隙。30例IMPC中,单纯IMPC者占43.3%,伴有浸润性导管癌及导管内癌者占56.7%;IMPC淋巴结转移率86.7%,显著高于IDC的56.4%;淋巴结转移个数比较差异显著;IMPC脉管瘤栓率90%,显著高于IDC的10.3%。免疫组化:IMPC(IDC)ER、PR、c-erb B-2、p53、Ki-67和CD44V6阳性率分别为90%(69.9%)、80%(56.4%)、66.7%(48.7%)、53.3%(53.9%)、63.3%(79.5%)和86.67%(94.9%);IMPC中ER、PR的阳性率显著高于IDC,两者比较差异显著(P<0.05);余免疫组化指标两者间比较不显著。结论 IMPC与IDC相比,前者具有较高的淋巴结转移率,预后相对较差,ER、PR高表达并不表示其预后较好;其高转移潜能与ER、PR、c-erb B-2、p53、Ki-67和CD44V6的阳性表达及肿瘤自身的大小无关,可能与微乳头状的生长方式有关。
Objective To explore the clinical and pathological features,immunohistochemical expression and prognosis of invasive micropapillary carcinoma of the breast（ IMPC）. Methods Thirty cases of invasive breast carcinoma with an IMPC component were reviewed. The histopathologic changes and immunophenotype of the 30 cases were studied with review of the literature. Results Histologically,the characteristic features of the tumor usually showed morule-like cluster,small glandular patten,or micropapillary pattern. There was obvious interspace between cancer nests and peritumoral stroma. Of the 30 patients,43. 33%（ 13 cases） had MPC only,56. 67%（ 17 cases） were accompanied by invasive ductal carcinoma. The positive rate of axillary lymph node metastasis was 86. 7%,which was significantly higher than that of invasive ductal carcinoma（ IDC）（ 56. 4%）. The rate of lymphatic and vascular invasion in IMPC was also higher than that of IDC. C-erb B-2,P53,Ki-67 and CD44V6 had no significant differences between IMPC and IDC. ER and PR were significantly more positivity in IMPC cases. Conclusion Compared with IDC,IMPC has a higher lymph node metastasis rate. The high metastatic potential has no correlated with the expression of ER,PR,C-erb B-2,P53,Ki-67 and CD44V6. The size has no direct relevance with high invasive ability,lymph node metastasis and prognosis of the tumor. Our findings suggest that the high metastatic potential may be associated with the micropapillary growth pattern.
出处
《诊断病理学杂志》
CSCD
2015年第8期459-463,共5页
Chinese Journal of Diagnostic Pathology
关键词
乳腺肿瘤
浸润性微乳头状癌
预后
免疫组化
淋巴结转移
Breast tumor
Invasive micropapillary carcinoma
Prognosis
Immunohistochemistry
Lymphatic metastasis
