生殖系统和乳腺疾病乳腺前列腺疾病.pptxVIP

生殖系统和乳腺疾病（二）

Diseasesofgenitalsystemand

mammarygland;Content;乳腺癌

Carcinomaofbreast

;;Anormalductcells

Bbasementmembrane

Clumen(centerofduct);2/6/2023;2/6/2023;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

;Thecellsofthisbreastcarcinomaarehighlypositiveforestrogenreceptorwiththisimmunoperoxidasestain.Estrogenreceptorpositivitycorrelateswithabetterprognosis（预后）.;Thisisprogesteronereceptor(PR)positivityinabreastcarcinoma.Theusefulnessofthisdeterminationisnotaswellestablishedasforestrogenreceptors.CarcinomasthatarePRpositive,butnotERpositive,mayhaveaworseprognosis.;分类：;属于原位癌

没有突破导管和腺泡旳基底膜

分类:导管内原位癌

小叶原位癌

;1．导管内原位癌

（Intraductalcarcinomainsitu）;Anormalductcells

Bductalcancercells

Cbasementmembrane

Dlumen(centerofduct);;（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;Comedocarcinomaischaracterizedbythepresenceofrapidlyproliferating,high-grademalignantcells.Thecellsinthecenteroftheductsareoftennecroticandcalcify.Thiscentralnecrosisleadstothegrosscharacteristicofextrusionofcheesymaterialfromtheductswithpressure.;2/6/2023;Comedocarcinoma

Notecentralnecrosis(*)andpleomorphicnuclei.Thecellsdonotextend

beyondthebasementmembrane(arrow).;;(2)非粉刺型导管内癌

（Noncomedointraductalcarcinoma）

;2/6/2023;2/6/2023;2/6/2023;2/6/2023;2.小叶原位癌;Anormallobularcells

Blobularcancercells

Cbasementmembrane;2/6/2023;Lobularcarcinomainsituconsistsofaneoplasticproliferation（增殖）ofcellsintheterminalbreastductsandacini.Thecellsaresmallandround.Thereisa30%riskfordevelopmentofinvasivecarcinomainthesameortheoppositebreast.;2/6/2023;2/6/2023;

导管内癌－－乳头、乳晕

乳头、乳晕可见渗出、浅表溃疡

又称“湿疹样癌”

表皮内