摘要
目的 观察乳腺浸润性微乳头状癌的形态与生物学行为之间的关系。方法 对 2 0 88例术前没有作活检取材 (仅经细胞学或细针穿刺活检诊断 )的乳腺癌乳腺切除标本做全乳腺切片检查 ,其中浸润性导管癌 1880例 ,观察浸润性微乳头状癌的临床病理学特征及光镜、电镜下的形态学表现。结果 浸润性微乳头状癌的发生率为 6.2 % (117/1880 ) ,其淋巴管侵犯 (54 7% ,58/10 6)、淋巴结转移阳性率 (76 4% ,81/10 6)及转移的个数 (平均 9 6)均明显的高于浸润性导管癌。光镜下特征性表现为癌巢由呈集块型或 (和 )腺管型的微乳头状癌巢组成 ,与网状间质间形成明显的空隙 (主间质分离 )。电镜下见癌巢与间质接触侧的细胞表面有大量的微绒毛 ,与间质的结合弱 ;癌细胞质内含有丰富的细丝 ;间质内见丰富的脉管。结论 浸润性微乳头状癌的淋巴管侵袭力强和淋巴结转移率高 。
ObjectiveTo clarify the relationship between biologic behavior and morphologic features of invasive micropapillary carcinoma (IMPC) of the breast. MethodsTwo thousand and eighty-eight cases of clinically defined monocentric breast cancer without pre-operative biopsy (except fine needle aspiration procedure) were examined by whole mammary gland serial sectioning. The clinicopathologic and morphologic features (including microscopic and ultrastructural) of IMPC were analyzed. ResultsOne hundred and seventeen cases of IMPC (6.2%,117/1 880) were diagnosed during the period of study. The incidence of lymphovascular invasion (54. 7%, 58/106)and nodal metastases (76.4%,81/106) was significantly higher in IMPC, as well as th e number of metastatic node (on average 9.6) was significantly more in IMPC, as compared with that of the invasive ductal carcinoma. Microscopically, the tumor was characterized by morula-like clusters and small papillae of malignant cells floating within irregular interstitial spaces and separated by fibrous septa. Ultrastructurally, microvilli were observed on the neoplastic cell surface at the periphery of the micropapillae. There were also numerous fine intermediate filaments in the cytoplasm. Newly formed capillaries were noted in the interstitium and some tumor cells were directly in contact with endothelial cells. ConclusionsA predominant component of IMPC in breast carcinoma is associated with a higher risk of lymphovascular invasion and nodal metastasis. The aggressive behavior of IMPC can be attributed to the proliferative activity of the tumor cells, and its associated angiogenesis.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2004年第1期21-25,共5页
Chinese Journal of Pathology
基金
日本厚生科学研究费资助(H1 0长寿080)
