中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
22期
1-3,4
,共4页
乳腺肿瘤%大汗腺癌%免疫组织化学%雄激素受体
乳腺腫瘤%大汗腺癌%免疫組織化學%雄激素受體
유선종류%대한선암%면역조직화학%웅격소수체
Mammary carcinoma%Apocrine carcinoma%Immunohistochemistry%Androgen receptor
目的：探讨乳腺大汗腺癌（AC）的临床和病理学特征。方法：筛选出的8例乳腺大汗腺癌进行临床病理分析，采用过碘酸雪夫（PAS）、阿辛蓝（AB）染色及免疫组织化学A-P法检测GCDFP-15、Mucin-1、Ki-67、雄激素受体（Androgen receptor，AR）、雌激素受体（estrogen receptor，ER）、C-erbB-2。结果：8例均发生于中老年女性，因发现乳房包块就诊。组织学8例均为高级核，其中大汗腺导管原位癌（ADCIS）1例， ADCIS伴浸润性大汗腺癌（IAC）5例，IAC伴非大汗腺型DCIS灶2例。镜下主要有2种形态：A型，胞质嗜伊红染的粗颗粒状；B型，胞质淡染，呈细粉尘颗粒状，如毛玻璃样。8例AC的PAS染色阳性，AB染色在ADCIS阴性，在IAC可有50%细胞阳性，并同时表达GCDPF-15，AR，Mucin-1及Ki-67；除1例外，ER均不表达。结论：乳腺大汗腺癌的临床表现和大体形态与非乳腺大汗腺癌相似，多发生于单侧并且多数伴有同侧腋窝淋巴结转移，预后较好。其诊断主要依靠病理：（1）特征性的AC型细胞；（2）GCDPF-15阳性率高；（3） AR阳性率高，ER阳性率低。
目的：探討乳腺大汗腺癌（AC）的臨床和病理學特徵。方法：篩選齣的8例乳腺大汗腺癌進行臨床病理分析，採用過碘痠雪伕（PAS）、阿辛藍（AB）染色及免疫組織化學A-P法檢測GCDFP-15、Mucin-1、Ki-67、雄激素受體（Androgen receptor，AR）、雌激素受體（estrogen receptor，ER）、C-erbB-2。結果：8例均髮生于中老年女性，因髮現乳房包塊就診。組織學8例均為高級覈，其中大汗腺導管原位癌（ADCIS）1例， ADCIS伴浸潤性大汗腺癌（IAC）5例，IAC伴非大汗腺型DCIS竈2例。鏡下主要有2種形態：A型，胞質嗜伊紅染的粗顆粒狀；B型，胞質淡染，呈細粉塵顆粒狀，如毛玻璃樣。8例AC的PAS染色暘性，AB染色在ADCIS陰性，在IAC可有50%細胞暘性，併同時錶達GCDPF-15，AR，Mucin-1及Ki-67；除1例外，ER均不錶達。結論：乳腺大汗腺癌的臨床錶現和大體形態與非乳腺大汗腺癌相似，多髮生于單側併且多數伴有同側腋窩淋巴結轉移，預後較好。其診斷主要依靠病理：（1）特徵性的AC型細胞；（2）GCDPF-15暘性率高；（3） AR暘性率高，ER暘性率低。
목적：탐토유선대한선암（AC）적림상화병이학특정。방법：사선출적8례유선대한선암진행림상병리분석，채용과전산설부（PAS）、아신람（AB）염색급면역조직화학A-P법검측GCDFP-15、Mucin-1、Ki-67、웅격소수체（Androgen receptor，AR）、자격소수체（estrogen receptor，ER）、C-erbB-2。결과：8례균발생우중노년녀성，인발현유방포괴취진。조직학8례균위고급핵，기중대한선도관원위암（ADCIS）1례， ADCIS반침윤성대한선암（IAC）5례，IAC반비대한선형DCIS조2례。경하주요유2충형태：A형，포질기이홍염적조과립상；B형，포질담염，정세분진과립상，여모파리양。8례AC적PAS염색양성，AB염색재ADCIS음성，재IAC가유50%세포양성，병동시표체GCDPF-15，AR，Mucin-1급Ki-67；제1예외，ER균불표체。결론：유선대한선암적림상표현화대체형태여비유선대한선암상사，다발생우단측병차다수반유동측액와림파결전이，예후교호。기진단주요의고병리：（1）특정성적AC형세포；（2）GCDPF-15양성솔고；（3） AR양성솔고，ER양성솔저。
To investigate the clinicopathological features and the immunohistochemica phenotype of apocrine carcinoma(AC)of breast. Method:The clinical and pathologic features of 8 cases with AC in breast were investigated. Periodic-acid-Schiff(PAS),alcian-blue staining were performed. The immunohistochemical study was performed by a panel of antibodies including gross cystic disease fluid protein 15(GCDFP-15),Mucin-1,AR,ER, c-erb-2 and Ki-67. Result:All 8 cases occurred in middle to old age female patients,complaining of mass in breast. Histologically,8 cases of apocrine carcinomas with high nuclear grade were confirmed,including 1 ADCIS,5ADCIS with IAC and 2 IAC. Two types of AC cells were noted according to the morphologic of cytoplasm:A type,neoplastic cells with copious,granular eosinophilic cytoplasm;B type,carcinoma cells with finely granular pale cytoplasm,like frosting glass. AC cells of 8 cases showed positivity for PAS,AB was negative in ADCIS and 50%positivity in IAC. 8 cases expressed GCDFP-15,AR,Mucin-1,Ki-67,all but 1 case was negative for ER. Conclusions:The clinic features of AC is similar to non-AC,frequency in unilateral and lymph node metastases in ipsilateral armpit,same prognosis with other types of breast carcinoma. Diagnosis of AC mainly depend on pathology:(1)Morphologicly,cells possessed of apocrine carcinoma features. (2)The positivity rate of GCDFP-15 is high.(3)The positivity rate of AR is high but low incident rate of positive ER.
