乳腺囊性病变的临床病理分析.pdfVIP

生 筮 鲞 nese Journal of Practical Medicine June．2008．Vo1．35．No．12 · 21· 乳腺囊性病变的临床病理分析 刘福川 陈守菊 刘文莉 (四川省达州市中心医院，达州 635000) 【摘要】 目的 探讨乳腺囊性病变与囊性增生症的关系及其临床意义。方法 收集近3年来诊治的乳腺囊性病变32 例的临床资料，分析其临床、影像及病理学特点。并另选10例乳腺癌旁2 cm内的病变做对照分析。部分病例行免疫组 化检测Calponin、P63、actin、34 J3E12、S一100了解肌上皮表达情况。结果 32例中乳腺囊性增生症16例、导管扩张症5 例、乳汁潴留囊肿4例、粘液囊肿样病变1例、单纯囊肿6例。16例“乳腺囊性增生症”均为良性上皮增生，包括硬化性 腺病2例、盲管性腺病1例、腺肌上皮腺病3例、导管内乳头状肿瘤10例(中央型6例，外周型乳头状瘤4例)；其中非典 型乳头状瘤3例，其肌上皮标记相对减弱或消失。癌旁组织见囊性增生症1例，导管内乳头状瘤病5例。结论 囊性病 变是增生症的继发改变，囊性增生症的癌变风险在于部分病例的不典型性增生，尤其是非典型性乳头状增生。故临床病 理宜区分非典型性与普通型增生，不宜用囊性增生症术语并视之为癌前病变。 【关键词】 乳腺；囊性病变；囊性增生症 Clincopathological analysis of the breast cystic lesions Fuchuan，CHEN Sho M， 耽n Dazhou Central Hospital，Dazhou 635000，Sichuan 【Abstract】 Objective To implore the clinical significance and relationship between breast cystic lesion and cystic hyperpalsia．Methods The data of 32 cases of breast cystic lesion diagnosed and treated in the lat． est 3 years were collected，and their clinical features，image characteristics，pathological structures were ana— lyzed．Some cases were detected with Calponin，P63，actin，34[3E12 and S一100 by immunohistochemical test． Results 1 6 cases were the breast cystic hyperplasia，5 cases were mammary ductectasia，4 cases were galac— tocele．only one case was muoooele—like lesions and 6 cases were single cyst．The 16 cases with cystic hyper． plasia were all benign epithelial proliferation．Including 2 cases with sclerosing adenosis，one case with blunt ductal adenosis，3 cases were adenomyoepithelial adenosis，1 0 cases were intraductal papilloma，6 cases were central type，4 cases were peripheral type；and there were 3 cases of atypical papilloma，the myoepithelial mark— ers expressed weaken relatively or negative．1 case of cystic hyperplasia and 5 cases of papilloma were