【摘要】 目的探讨乳腺化生性癌(MC)的临床病理学特点。方法回顾性分析6例乳腺化生性癌的临床及病理学特点,其中包括2例鳞状细胞癌,3例含有鳞状细胞癌成分的腺癌(伴有鳞状分化的腺癌),1例癌伴间叶分化。对所有肿瘤组织进行形态学及免疫组化观察,结合临床资料进行分析并复习相关文献。结果 6例化生性癌患者均为女性,发病年龄30~70岁,平均53.5岁。临床上多以无痛性乳房肿块为首发症状,均行手术治疗。免疫组化显示伴有鳞状分化的腺癌中除1例ER和PR(+)外,其余ER、PR均(-);上皮标记物CK7、CK8、CK5、34βE12和E-cad均(+),p63部分(+);癌伴间叶分化中,间叶成分S-100、vimentin、SMA和CD10(+),ER和PR(+)均在导管癌区域表达;1例伴有鳞状分化的腺癌和1例鳞状细胞癌EGFR(+);6例cerb B-2均(-)。结论 MC是罕见的乳腺恶性肿瘤,病理形态学表现为多样性,免疫组化显示多数激素受体(-),根据化生的成分不同表达相应的上皮及间叶组织抗原。更多还原

【Abstract】 Objective To analyze the clinicopathologic characteristics of breast metaplastic carcinoma. Methods Six patients with metaplastic carcinoma of breast were retrospectively reviewed. Two cases were purely squamous cell carcinomas,three cases were adenocarcinoma with squamous metaplasia and the other one was carcinoma with mesenchymal differentiation. The clinical characteristics,pathological diagnosis and treatment were analyzed,and some related literature were reviewed. Results All six cases were women with median age of 53. 5 years( range 30-70 years). The patients all presented a single painless mass in the breast on presentation, who had undergone surgical resection.Immunohistochemically,squamous cell carcinomas and two cases of adenocarcinoma with squamous metaplasia were negative for ER and PR,while another adenocarcinoma with squamous metaplasia expressed ER( 40%) and PR( 30%).CK7,CK8,CK5,34βE12 and E-cad were all positive,EGFR was positive in one case of adenocarcinoma with squamous metaplasia,while Her-2 were negative in all the cases; CK7,34βE12 and E-cad were positive in carcinoma area of carcinoma with mesenchymal differentiation,and so as ER and PR( both were 60%),while S100,Vim,SMA and CD10 were positive in mesenchymal area. Conclusion MC is a rare and aggressive tumor with various pathomorphology types,which is negative for hormone receptors, but express other epithelium and lobus intermedius antibodies. To avoid misdiagnosis,relative IHC should be committed.更多还原