乳腺惡性導(dǎo)管內(nèi)乳頭狀病變28例臨床病理分析
發(fā)布時(shí)間：2018-08-12 17:53
【摘要】：目的探討乳腺惡性導(dǎo)管內(nèi)乳頭狀病變的臨床病理學(xué)特征、診斷、鑒別診斷及預(yù)后。方法回顧性分析28例乳腺惡性導(dǎo)管內(nèi)乳頭狀病變的臨床表現(xiàn),觀察其組織病理學(xué)及免疫表型特征,收集隨訪資料并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 28例患者均為女性,平均年齡55.7歲,主要表現(xiàn)為乳頭溢液和乳腺腫塊。組織學(xué)類型:導(dǎo)管內(nèi)乳頭狀癌22例、包膜內(nèi)乳頭狀癌2例及實(shí)性乳頭狀癌4例。鏡檢:腫瘤呈乳頭狀或?qū)嶓w狀,可見纖細(xì)的纖維血管軸心。腫瘤細(xì)胞形態(tài)多一致,細(xì)胞核級(jí)別低。免疫組化標(biāo)記示大部分患者腫瘤細(xì)胞ER和PR均呈強(qiáng)陽性,HER-2、CK5/6均呈陰性;結(jié)節(jié)內(nèi)CK5/6、p63、SMA均呈陰性。實(shí)性型者部分可表達(dá)CD56、Syn、CgA。Ki-67增殖指數(shù)平均為5.3%。27例獲得隨訪資料,隨訪10~79個(gè)月,患者均存活。結(jié)論乳腺惡性導(dǎo)管內(nèi)乳頭狀病變好發(fā)于老年女性,組織學(xué)形態(tài)多樣,診斷需結(jié)合臨床、組織學(xué)形態(tài)及免疫表型,應(yīng)與導(dǎo)管內(nèi)乳頭狀瘤鑒別。該腫瘤具有較為惰性的生物學(xué)行為,預(yù)后較好。
[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.
【作者單位】： 廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院;
【基金】：廣東省中醫(yī)藥局建設(shè)中醫(yī)藥強(qiáng)省科研項(xiàng)目(20141075)
【分類號(hào)】：R737.9
本文編號(hào)：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.
【作者單位】： 廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院;
【基金】：廣東省中醫(yī)藥局建設(shè)中醫(yī)藥強(qiáng)省科研項(xiàng)目(20141075)
【分類號(hào)】：R737.9
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