乳腺浸润性筛状癌临床病理分析.pdfVIP

维普资讯 临床与实验病理学杂志 JClinExpPathol2005Aug；20(4) ·433 · 乳腺浸润性筛状癌临床病理分析 郎志强，魏 兵，李新军，步 宏，张红英，陈卉娇，刘柏龄，杨 可 [摘要] 目的 探讨乳腺浸润性筛状癌 (invasivecribriformcarcinoma，ICC)的临床病理和免疫表型特点。方法 复习8例乳 腺 ICC的临床病理资料，并将其组织学特征、免疫表型和预后与浸润性导管癌进行比较。结果 乳腺 ICC发病平均年龄 42．9 岁，多表现为无痛性乳房肿块，影像学微钙化常见。组织学特征是不规则癌细胞团巢呈筛状结构浸润性生长，瘤细胞核级低 中等 ，多数病例核分裂象少见，胞质顶浆分泌和间质成纤维细胞增生易见，常并存筛状型导管原位癌和小管癌。免疫表型 显示CK3413E12高表达而CK5／6阴性 ，肌上皮标记阴性。8例中经典型6例 、混合型2例，其发病年龄、组织学分级 、腋淋巴结 转移率 、c．erbB．2和Ki-67阳性率均低于浸润性导管癌，近期随访结果显示预后优于浸润性导管癌。结论 乳腺 ICC作为 WHO新确定的浸润性癌类型，预后较好 ，需要与筛状型导管原位癌和腺样囊性癌等鉴别，免疫组化染色有助于确诊。 [关键词] 乳腺肿瘤；浸润性筛状癌；临床病理；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—4033一o5 lnvasivecribriform carcinomaofbreast~aclinicopathologicstudy LANGZhi-qiang，WEIBing，LIXin-jun，BUHong，ZHANGHong-ying，CHENHui-jiao，LiuBo-ling，YangKe (DepartmentofPathology，WestChinaHospital，SichuanUniversity，Chengdu 610041，China) [Abstract] Purpose Tostudytheclinic0patholocalandimmunohistochemicalcharacteristicsofinvasivecribriformcracinoma (ICC)ofthebreast．Methods Aretrospectiveanalysisof8casesofICCWas performedbycomparinghistopathological，immunohis- tochemical changesandprognosiswithinvasiveductal cracinoma．Results ThemeanageofICCpatientswas42．9．Th etumorusually presentedasapainlessmassfrequentlycontainingmicrocalcificationsatmammography．Histologically，ICCcontainedpredominantlyir- regulra cribrifomr arrangement，showingalowtomoderatedegreeofnuclera pleomorphism．Mitoseswererrae．Apical snoutsandprom— inentfibroblasticstromawerepresentinmanycases．Cribrifomr typeductal cracinomainsituandtubulra cracinomawerealsofrequent- lycoexisted．Immunohist0chemicaUy，ICCwasCK3413E12positiveandCK5／6negative，nomyoepithelialmrakerimmunostainingWas present．Therewere6classical and2mixedtypesofICCinthisstudy．Th emena age，histologicalrgade，percentageofaxillarynode metastasesandthepositivepercentageofc—erbB-2n