乳腺浸润性筛的状癌临床病理分析.pdf

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 ( invasive cribriform carcinoma, 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 4219 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 CK34βE12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、c2erbB22和 Ki267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 - 0433 - 05 Inva sive cr ibr iform carc inoma of brea st: a clin icopa tholog ic study LANG Zhi2qiang, W E IB ing, L I Xin2jun, BU Hong, ZHANG Hong2ying, CHEN Hui2jiao, L iu Bo2ling, Yang Ke (D epartm en t of Pa thology, W est China Hospita l, S ichuan U niversity, Chengdu　610041, Ch ina) [ Abstract] 　Purpose　To study the clinicopathological and immunohistochem ical characteristics of invasive cribriform carcinoma ( ICC) of the breast. M ethods　A retrospective analysis of 8 cases of ICC was performed by comparing histopathological, immunohis2 tochem ical changes and p rognosiswith invasive ductal carcinoma. Results　The mean age of ICC patientswas 4219. The tumor usually p resented as a painlessmass frequently containing m icrocalcifications atmammography. H istologically, ICC contained p redom inantly ir2 regular cribriform arrangement, showing a low to moderate degree of nuclear p leomorphism. M itoseswere rare. Ap ical snouts and p rom2 inent fibroblastic stroma were p resent in many cases. Cribriform type ductal carcinoma in situ and tubular carcinoma were also frequent2 ly coexisted. Immunohistochem ically, ICC was CK34βE12 positive and CK5 /6 negative, no myoep ithelial marker immunostaining was p resent. There were 6 classical and 2 m ixed types of ICC in this study. The mean age, histological grade, percentage of axillary node metastases and the positive percentage of