乳腺典型髓样癌与不典型髓样癌临床病理分析.pdfVIP

维普资讯 · 438 · 临床与实验病理学杂志 JClinExpPathol 2005Aug；20(4) 乳腺典型髓样癌与不典型髓样癌临床病理分析 张晓明 ，范娜娣 [摘要] 目的 探讨乳腺典型与不典型髓样癌的临床病理特征和生物学行为差异。方法 对乳腺典型髓样癌及不典型髓样 癌各2O例临床病理资料进行分析，并采用S-P法检测nm23、E·cad、p53、ER、PR、c—erbB-2、CD45RO和CD20的表达。结果 典 型髓样癌组 ，癌细胞合体性结构75％，无腺管结构，间质见弥漫性淋巴细胞浸润；不典型髓样癌组，可见腺管结构，间质无或 少量淋巴细胞浸润。免疫组化检测典型髓样癌nm23、E—cad阳性表达均高于不典型髓样癌。典型组随访 12～84月 (平均 37 个月)，均无腋下淋巴结转移，均健在；不典型组随访9～84月(平均29．5个月)，腋下淋巴结转移4／20例，其中4例分别于术 后 1 3年内死亡。结论 ①要严格掌握乳腺典型髓样癌与不典型髓样癌的病理诊断标准。②不典型髓样癌不完全等同 “乳 腺浸润性导管癌伴髓样特点。”③乳腺典型与不典型髓样癌的预后不同，前者明显优于后者。 [关键词] 乳腺肿瘤；典型髓样癌；不典型髓样癌；免疫组织化学 [中图分类号] R737，9 [文献标识码] A [文章编号] 1001—7399(2005)04—4038—04 Typicalandatypicalmedullarycarcinomasofbreast：aclinicopathologic【alanalysis ZHANG Xiao．ming ．FAN Lang．di (DepartmentofPathology， AffiliatedHospital，QiqiharMedicalCollege 161000，China；TianfinPathologi— calConsultationCenter． 口nin 300121，China) [Abstract] Purpose Toexploretheclinic叩atholocalfeatureandthedifferenceinbiologicalbehaviorbetweentypicalandatypi— calmedullarycarcinomasofthebreast．M ethods Westudiedtheclinicalpathologydatafrom 20patientsoftypical andtheatpy ical medullarycarcinomasofbreastwithimmunostaining(S-Pmethod)fornm23。E—cad，p53，ER，PR，CD45ROnadCD20．Results Inthetypical group，wefoundthatthesyneytial structureofcancercellsweremorethan75％ ，Therewerenotheglandularductstruc— tures，Diffuselymphocyticinfiltrationwasdetectedinthestroma．Intheatpy ical group，thestructureofglandulra ductcouldbedetec— tedandtherewerelessOrnothelymphocyticinfiltrationinthestroma Th epositiveratesofnm23nadE—cadwerehigherintpyicalme— dullarycarcinomathanthoseinatypicalmedullaycracinoma Following—upfor12to84months(mean37months)showedthatallpa— tientshadnometastasistoaxillarylymphnode，and allsurvivedin typical rgoup．Inatpyical rgoup，afterfollowing—upofr9 to84 months(mean29，5months)，4cases(4／20)hadmetastasestoaxillarylymphnodes，nad4casesweredead1to3yearsafteropera—