中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2008年
11期
743-748
,共6页
邬万新%韩文兰%张燕萍%喻其霞%温晓伟%陆宁%唐正英%袁琳娜%张怡%王振%王伟%杨宏杰%陈彩萍%郭文利
鄔萬新%韓文蘭%張燕萍%喻其霞%溫曉偉%陸寧%唐正英%袁琳娜%張怡%王振%王偉%楊宏傑%陳綵萍%郭文利
오만신%한문란%장연평%유기하%온효위%륙저%당정영%원림나%장이%왕진%왕위%양굉걸%진채평%곽문리
乳腺肿瘤%癌,基底细胞%免疫表型分型%诊断%预后
乳腺腫瘤%癌,基底細胞%免疫錶型分型%診斷%預後
유선종류%암,기저세포%면역표형분형%진단%예후
Breast neoplasms%Carcinoma,basal cell%Immunophenotyping%Diagnosis%Prognosis
目的 观察基底细胞样型乳腺癌(BLBC)的临床病理特征.方法 采用ER、PR、HER2、Ki-67、CK5/6、CK14和表皮生长因子受体(EGFR)进行免疫组织化学EnVision法检测458例女性浸润性乳腺癌以筛选BLBC,比较BLBC与其他免疫表型乳腺癌的临床病理特征.对其中228例浸润性乳腺癌患者进行了随访.结果 458例浸润性乳腺癌中发现BLBC 46例(10.0%).癌灶直径平均3.3 cm.58.7%(27/46)出现推挤性生长方式,52.2%(24/46)出现地图状坏死,30.4%(14/46)癌灶中心出现无细胞纤维化区域以及63.0%(29/46)癌灶周边和间质内有不同程度淋巴细胞浸润.癌细胞异型性明显,核分裂象多见,主要排列成不规则、紧密实性结构.Ki-67高表达(>25%)在BLBC中占43.5%(20/46).CK5/6、CK14和EGFR阳性分别见于58.7%(27/46)、43.5%(20/46)和65.2%(30/46)的BLBC病例.BLBC的3年累积生存率为66.9%,低于管腔A型乳腺癌,与HER2高表达型乳腺癌差异无统计学意义.结论 BLBC在女性浸润性乳腺癌中所占比例为10%,其组织结构和细胞形态具有一定特征性,但诊断BLBC仍必需结合其免疫表型.BLBC是预后比较差的乳腺癌亚型之一.
目的 觀察基底細胞樣型乳腺癌(BLBC)的臨床病理特徵.方法 採用ER、PR、HER2、Ki-67、CK5/6、CK14和錶皮生長因子受體(EGFR)進行免疫組織化學EnVision法檢測458例女性浸潤性乳腺癌以篩選BLBC,比較BLBC與其他免疫錶型乳腺癌的臨床病理特徵.對其中228例浸潤性乳腺癌患者進行瞭隨訪.結果 458例浸潤性乳腺癌中髮現BLBC 46例(10.0%).癌竈直徑平均3.3 cm.58.7%(27/46)齣現推擠性生長方式,52.2%(24/46)齣現地圖狀壞死,30.4%(14/46)癌竈中心齣現無細胞纖維化區域以及63.0%(29/46)癌竈週邊和間質內有不同程度淋巴細胞浸潤.癌細胞異型性明顯,覈分裂象多見,主要排列成不規則、緊密實性結構.Ki-67高錶達(>25%)在BLBC中佔43.5%(20/46).CK5/6、CK14和EGFR暘性分彆見于58.7%(27/46)、43.5%(20/46)和65.2%(30/46)的BLBC病例.BLBC的3年纍積生存率為66.9%,低于管腔A型乳腺癌,與HER2高錶達型乳腺癌差異無統計學意義.結論 BLBC在女性浸潤性乳腺癌中所佔比例為10%,其組織結構和細胞形態具有一定特徵性,但診斷BLBC仍必需結閤其免疫錶型.BLBC是預後比較差的乳腺癌亞型之一.
목적 관찰기저세포양형유선암(BLBC)적림상병리특정.방법 채용ER、PR、HER2、Ki-67、CK5/6、CK14화표피생장인자수체(EGFR)진행면역조직화학EnVision법검측458례녀성침윤성유선암이사선BLBC,비교BLBC여기타면역표형유선암적림상병리특정.대기중228례침윤성유선암환자진행료수방.결과 458례침윤성유선암중발현BLBC 46례(10.0%).암조직경평균3.3 cm.58.7%(27/46)출현추제성생장방식,52.2%(24/46)출현지도상배사,30.4%(14/46)암조중심출현무세포섬유화구역이급63.0%(29/46)암조주변화간질내유불동정도림파세포침윤.암세포이형성명현,핵분렬상다견,주요배렬성불규칙、긴밀실성결구.Ki-67고표체(>25%)재BLBC중점43.5%(20/46).CK5/6、CK14화EGFR양성분별견우58.7%(27/46)、43.5%(20/46)화65.2%(30/46)적BLBC병례.BLBC적3년루적생존솔위66.9%,저우관강A형유선암,여HER2고표체형유선암차이무통계학의의.결론 BLBC재녀성침윤성유선암중소점비례위10%,기조직결구화세포형태구유일정특정성,단진단BLBC잉필수결합기면역표형.BLBC시예후비교차적유선암아형지일.
Objective To study the elinicopathologic characteristics of basal-like immunophenotype breast cancer (BLBC). Methods 458 cases of female infiltrative breast cancer were studied using immunohistochemical staining with an antibody panel of ER, PR, HER2, Ki-67, CK5/6, CK14 and epidermal growth factor receptor (EGFR) and were classified basing on the immunophenotypes. The clinicopathologic characteristics were compared with other immunophenotypes of breast cancer. 228 of 458 cases of breast cancer were followed up. Results 46 cases of BLBC were screened out among the 458 breast cancers. And histological features of BLBC were analysed including the larger diameter of cancer foci ( average 3.3 cm ), appearance of squeezing phenomenon of neighboring cell borders ( 58.7%, 27/46 ),geography-like distribution of necrosis ( 52.2%, 24/46 ), central zone fibrosis ( 30.4%, 14/46 ) and lymphoplasmacytic infiltration at the margin and stroma (63.0% ,29/46). There were nuclear pleomorphism with numerous mitoses. The cancer cells were closely arranged, forming irregular solid architectures . There was a high expression ( > 25% ) of Ki-67 (43.5% ,20/46). CK5/6, CK14 and EGFR were positive in 58.7%(27/46), 43.5% (20/46)and 65.2% (30/46)respectively. 3-year survival rate of BLBC was 66.9%, lower than the luminal A breast cancer and similar to HER2 over-expression breast cancer.Conclusions The proportion of BLBC in the group of breast cancers is 10%. BLBC has its distinct histological and cytological features. Currendy, it is still necessary to depend on immunophenotyping in making a BLBC diagnosis. BLBC is the one of breast cancer subtypes with the poorest prognosis.
