乳腺恶性导管内乳头状病变28例临床病理分析
发布时间：2018-08-12 17:53
【摘要】：目的探讨乳腺恶性导管内乳头状病变的临床病理学特征、诊断、鉴别诊断及预后。方法回顾性分析28例乳腺恶性导管内乳头状病变的临床表现,观察其组织病理学及免疫表型特征,收集随访资料并复习相关文献。结果 28例患者均为女性,平均年龄55.7岁,主要表现为乳头溢液和乳腺肿块。组织学类型:导管内乳头状癌22例、包膜内乳头状癌2例及实性乳头状癌4例。镜检:肿瘤呈乳头状或实体状,可见纤细的纤维血管轴心。肿瘤细胞形态多一致,细胞核级别低。免疫组化标记示大部分患者肿瘤细胞ER和PR均呈强阳性,HER-2、CK5/6均呈阴性;结节内CK5/6、p63、SMA均呈阴性。实性型者部分可表达CD56、Syn、CgA。Ki-67增殖指数平均为5.3%。27例获得随访资料,随访10~79个月,患者均存活。结论乳腺恶性导管内乳头状病变好发于老年女性,组织学形态多样,诊断需结合临床、组织学形态及免疫表型,应与导管内乳头状瘤鉴别。该肿瘤具有较为惰性的生物学行为,预后较好。
[Abstract]:Objective To investigate the clinicopathological features, diagnosis, differential diagnosis and prognosis of malignant intraductal papillary lesions of the breast.Methods The clinical manifestations of 28 cases of malignant intraductal papillary lesions of the breast were retrospectively analyzed.The histopathological and immunophenotypic features were observed.The follow-up data were collected and the relevant literature was reviewed. The average age was 55.7 years. The main manifestations were nipple discharge and breast mass. Histological types: intraductal papillary carcinoma 22 cases, capsular papillary carcinoma 2 cases and solid papillary carcinoma 4 cases. Most of the patients were strongly positive for ER and PR, but negative for HER-2 and CK5/6, and negative for CK5/6, p63 and SMA in nodules. The proliferative index of CD56, Syn and CgA.Ki-67 was 5.3% in solid type. 27 patients were followed up for 10-79 months and all survived. It should be differentiated from intraductal papilloma because of its clinical, histological and immunophenotypic features.
【作者单位】： 广州中医药大学第一附属医院;
【基金】：广东省中医药局建设中医药强省科研项目(20141075)
【分类号】：R737.9
本文编号：2179839
[Abstract]:Objective To investigate the clinicopathological features, diagnosis, differential diagnosis and prognosis of malignant intraductal papillary lesions of the breast.Methods The clinical manifestations of 28 cases of malignant intraductal papillary lesions of the breast were retrospectively analyzed.The histopathological and immunophenotypic features were observed.The follow-up data were collected and the relevant literature was reviewed. The average age was 55.7 years. The main manifestations were nipple discharge and breast mass. Histological types: intraductal papillary carcinoma 22 cases, capsular papillary carcinoma 2 cases and solid papillary carcinoma 4 cases. Most of the patients were strongly positive for ER and PR, but negative for HER-2 and CK5/6, and negative for CK5/6, p63 and SMA in nodules. The proliferative index of CD56, Syn and CgA.Ki-67 was 5.3% in solid type. 27 patients were followed up for 10-79 months and all survived. It should be differentiated from intraductal papilloma because of its clinical, histological and immunophenotypic features.
【作者单位】： 广州中医药大学第一附属医院;
【基金】：广东省中医药局建设中医药强省科研项目(20141075)
【分类号】：R737.9
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