中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
19期
40-43
,共4页
乳腺%浸润性微乳头状癌%病理学%免疫组化
乳腺%浸潤性微乳頭狀癌%病理學%免疫組化
유선%침윤성미유두상암%병이학%면역조화
Breast%Invasive micropapillary carcinoma%Pathology%Immunohistochemistry
目的：探讨乳腺浸润性微乳头状癌（IMPC）的临床病理特征、免疫组化表达、诊断及鉴别诊断。方法：对11例IMPC患者的临床病理资料进行观察分析，运用免疫组化方法分析这组病例ER、PR、Her-2、EMA、E-Cadherin、CD31、p53、Ki-67的表达。结果：11例IMPC患者无特殊临床症状和体征。特征性组织学表现为肿瘤细胞呈微乳头状或腺样排列，细胞呈里面朝外（inside-out）的排列方式；肿瘤细胞团由纤细的纤维组织分隔，形成主间质分离。印片细胞特征性形态学表现为桑葚体样细胞球表面细胞质呈微绒毛样改变。11例中7例有血管淋巴管癌栓，淋巴结转移率63.64%。免疫组化EMA线状表达于微乳头和腺样结构的外侧缘；E-Cadherin肿瘤细胞间连接面的细胞膜强表达，而间质面的细胞膜表达减弱。Ki-67表达率平均30.3%。ER阳性率81.81%， PR阳性率72.73%。Her-2阳性率（+++）18.18%。结论：IMPC为一种具有特殊形态学表现的高增殖、高转移潜能的乳腺癌。特征性组织形态学结合免疫组化E-Cadherin、EMA等检测有助于IMPC的诊断和鉴别诊断。
目的：探討乳腺浸潤性微乳頭狀癌（IMPC）的臨床病理特徵、免疫組化錶達、診斷及鑒彆診斷。方法：對11例IMPC患者的臨床病理資料進行觀察分析，運用免疫組化方法分析這組病例ER、PR、Her-2、EMA、E-Cadherin、CD31、p53、Ki-67的錶達。結果：11例IMPC患者無特殊臨床癥狀和體徵。特徵性組織學錶現為腫瘤細胞呈微乳頭狀或腺樣排列，細胞呈裏麵朝外（inside-out）的排列方式；腫瘤細胞糰由纖細的纖維組織分隔，形成主間質分離。印片細胞特徵性形態學錶現為桑葚體樣細胞毬錶麵細胞質呈微絨毛樣改變。11例中7例有血管淋巴管癌栓，淋巴結轉移率63.64%。免疫組化EMA線狀錶達于微乳頭和腺樣結構的外側緣；E-Cadherin腫瘤細胞間連接麵的細胞膜彊錶達，而間質麵的細胞膜錶達減弱。Ki-67錶達率平均30.3%。ER暘性率81.81%， PR暘性率72.73%。Her-2暘性率（+++）18.18%。結論：IMPC為一種具有特殊形態學錶現的高增殖、高轉移潛能的乳腺癌。特徵性組織形態學結閤免疫組化E-Cadherin、EMA等檢測有助于IMPC的診斷和鑒彆診斷。
목적：탐토유선침윤성미유두상암（IMPC）적림상병리특정、면역조화표체、진단급감별진단。방법：대11례IMPC환자적림상병리자료진행관찰분석，운용면역조화방법분석저조병례ER、PR、Her-2、EMA、E-Cadherin、CD31、p53、Ki-67적표체。결과：11례IMPC환자무특수림상증상화체정。특정성조직학표현위종류세포정미유두상혹선양배렬，세포정리면조외（inside-out）적배렬방식；종류세포단유섬세적섬유조직분격，형성주간질분리。인편세포특정성형태학표현위상심체양세포구표면세포질정미융모양개변。11례중7례유혈관림파관암전，림파결전이솔63.64%。면역조화EMA선상표체우미유두화선양결구적외측연；E-Cadherin종류세포간련접면적세포막강표체，이간질면적세포막표체감약。Ki-67표체솔평균30.3%。ER양성솔81.81%， PR양성솔72.73%。Her-2양성솔（+++）18.18%。결론：IMPC위일충구유특수형태학표현적고증식、고전이잠능적유선암。특정성조직형태학결합면역조화E-Cadherin、EMA등검측유조우IMPC적진단화감별진단。
Objective:To discuss the clinical and pathological features,immunohistochemical expression, diagnosis and differential diagnosis of invasive micropapillary carcinoma of the breast(IMPC).Method:The clinicopathologic information of 11 cases of IMPC were studied,and the expression of ER,PR,Her-2,EMA,E-Cadherin, CD31,p53 and Ki-67 of this group were analyzed by immunohistochemistry staining.Result:11 cases of IMPC were not special clinical symptoms.Histological findings were characterized that tumor cells were arranged like micro-papillary or glandular mode,and inside cells were outward arrangement (inside-out).Tumor cells were separated by slender fibrous septa,and formed the main interstitial separation.The characteristic performance of the imprint cytology usually showed modula-like cluster,and the cytoplasm on the cell surface was microvilli-like.Among the 11 cases of IMPC studied,7 cases had lymphatic tumor emboli.The incidence of regional lymph node metastasis was 63.64%.Immunohistochemical EMA was expressed in the outer rim of the Micro papillary and adenoid structure.E-Cadherin was strong expressed in the membrane of contiguous surfaces among carcinoma cells but the expression of interstitial surface membrane decreased. Expression rate of Ki-67 was 30.3% on average.Positive rate of ER was 81.81%.Positive rate of PR was 72.73%.Positive rate of Her-2 was 18.18% (+++).Conclusion:IMPC is special morphology type of invasive breast cancer with high proliferation and metastasis potential.Combining with EMA,E-Cadherin markers,histomorphology characteristic of IMPC is helpful to its the diagnosis and differential diagnosis.
