第12章 生殖系统和乳腺疾病2-乳腺、前列腺疾病-课件.pptVIP

生殖系统和乳腺疾病（二） Diseases of genital system and mammary gland;Content; 乳 腺 癌  Carcinoma of breast;小导管;A normal duct cells B basement membrane C lumen (center of duct);Date;Date;导管双层上皮 内腺上皮，外肌上皮;全球每年120万妇女患乳腺癌，50万死于该病 北美、北欧高 我国↑3%/年，“第一癌症杀手” 40-60岁女性，男性罕见1% 乳腺外上象限中央区内上象限 来自乳腺终末导管小叶单元上皮; ER、PR (+)：内分泌治疗好，预后好 C-erbB-2 (+), ER (-): 预后差 ;The cells of this breast carcinoma are highly positive for estrogen receptor with this immunoperoxidase stain. Estrogen receptor positivity correlates with a better prognosis（预后）.;This is progesterone receptor (PR) positivity in a breast carcinoma. The usefulness of this determination is not as well established as for estrogen receptors. Carcinomas that are PR positive, but not ER positive, may have a worse prognosis.;分类：; 属于原位癌 没有突破导管和腺泡的基底膜 分类: 导管内原位癌 小叶原位癌 ; 1．导管内原位癌（Intraductal carcinoma in situ）;A normal duct cells B ductal cancer cells C basement membrane D lumen (center of duct);Intraductal carcinoma. The neoplastic（肿瘤的） cells are confined to the duct by the basement membrane. The neoplastic cells are monotonous with round to oval nuclei and little pleomorphism. The cell borders are well demarcated（区分）. ;（1）粉刺癌; 镜下: 实性排列，中央坏死－特征 癌细胞大，嗜酸，大小不一，核仁明显， 病理性核分裂多 坏死区常见钙化 导管周间质纤维组织↑，慢性炎C浸润;Comedocarcinoma is characterized by the presence of rapidly proliferating, high-grade malignant cells. The cells in the center of the ducts are often necrotic and calcify. This central necrosis leads to the gross characteristic of extrusion of cheesy material from the ducts with pressure.;Date; Comedocarcinoma Note central necrosis (*) and pleomorphic nuclei. The cells do not extend beyond the basement membrane (arrow).;; (2)非粉刺型导管内癌 （Noncomedo intraductal carcinoma） ;Date;Date;Date;Date;2.小叶原位癌;A normal lobular cells B lobular cancer cells C basement membrane;Date;Lobular carcinoma in situ consists of a neoplastic proliferation（增殖） of cells in the terminal breast