乳腺多形细胞癌临床病理分析

【作者】 赵晶； 陈凌； 傅西林； 付丽；

【机构】 天津医科大学附属肿瘤医院乳腺病理研究室；

【摘要】 目的:探讨乳腺多形细胞癌的临床病理学特征及其诊断、鉴别诊断。方法:根据2003年乳腺肿瘤WHO组织学分类标准,从浸润性非特殊型癌患者中重新诊断出乳腺多形细胞癌5例,结合其临床病理资料进行分析,并应用免疫组化技术检测肿瘤组织中。ER、PR、C—erbB-2、PCNA、 P53、EMA、AEI／AE3(CK1)、S-100及Bcl-2等生物学指标表达情况。结果:全组患者均为女性,年龄33—50岁, 平均43．6岁,肿物直径1-15cm,平均5．4 cm,临床TNM分期中,1例I期,3例Ⅱ期患者,余一例为Ⅲ期患者,全组均接受根治术或改良根治术。肿瘤组织HE染色显示,癌组织中多形性巨细胞明显增多,其比例为50—80％,核分裂相常见。所有肿瘤组织学分类均为Ⅲ级。1例患者出现腋下淋巴结转移,转移率为1／35,另一例出现皮肤及胸肌受累。免疫组化结果:乳腺多形细胞癌中,ER、PR两指标均为阴性表达,PCNA、AE1／AE3(CK1)则均为100％阳性表达, 且强阳性表达率为80％和100％。60％(3／5)和40％(2／5) 患者P53、S-100为阳性表达,而Bcl-2在全组病例中只见少量弱阳性表达。结论: 乳腺多形细胞癌是一种恶性度较高肿瘤,其细胞高度增殖,预后较差,需结合其组织学形态做出正确诊断。更多还原

【Abstract】 Objective: To investigate the clinicopatho-logic characteristics of polymorphic carcinoma of the breast and its histologic diagnosis and differential diagnosis. Methods: According to the breast tumors classification of the world health organization in 2003, five patients with breast polymorphic cancer were re-diagnosed from infiltrating ductal carcinoma. Reviewing the group of patients’ medical data, HE dying and immunohistochemical(IHC) staining for ER、 PR、 C-erbB-2、 PCNA. P53、 EMA、 AE1/AE3( CK1)、 S-100 and Bcl-2 were done. Results: All patients were female. The age of patients ranged from 33 to 50 years (mean=43.6yrs) and the average diameter of the tumors is 5.4cm. One case was stage I, three were stage II and the other one was stage III. All patients were accepted radical mastectomy or modified radical mastectomy. Histological, the 50 to 80 percent of the tumor manifested a pleomorphic cell population and all were grade EDI carcinoma with a high mitotic rate. Only one axillary lymph node contained metastasis in one case, and in another case, the tumor involving the skin and pectoralis. IHC showed the expression of ER and PR were negative and PCNA、 AE1/AE3 ( CK1) were positive, furthermore the ratio of hyper-positive were 80% and 100%. 60% and 40% tumors presented inununological activity to P53 and S-100, while Bcl-2 only showed weakly positive. Conclusion: Pleomorphic carcinoma of the breast is a prognostically unfavourable lesion. Correct diagnosis depended on the detailed pathological assessment更多还原