CAJ | 학술논문

目的：观察乳腺导管内乳头状肿瘤(intraductal papillary neoplasms，IDPN)的形态学和免疫表型特征，并探讨其诊断。方法根据WHO分类(2012)有关标准，筛选出乳腺导管内乳头状肿瘤82例，对上述病例进行HE形态观察和免疫组化检测，选用的一抗有CK5/6、CK34pEl2、CK8、SMA、p63、CD10。结果82例IDPN患者中导管内乳头状瘤(IDPMa)64例，乳头状瘤伴ADH和DCIS 12例，导管内乳头状癌(IDPC)6例。IDPN在形态学上表现为不同程度的上皮细胞和间质增生，以及继发病变等，这些使病灶呈现异常复杂的多样性。免疫组织化学SMA均为强阳性，各组间无明显差异；p63和CDlO的染色分布在IDPMa与IDPC两组间差异有统计学意义(均P<0.001)。细胞角蛋白(CK5/6)染色显示良性病变的表达呈镶嵌状阳性表达，在IDPC中表达明显减少或缺如，二者相比差异有统计学意义(P＜0.001)。结论 IDPN是一组组织学改变复杂的疾病，应注意其诊断标准的掌握。肌上皮、细胞角蛋白和腺腔上皮标志物联合应用在该组复杂病变中有很好的诊断和鉴别诊断价值。
목적：관찰유선도관내유두상종류(intraductal papillary neoplasms，IDPN)적형태학화면역표형특정，병탐토기진단。방법근거WHO분류(2012)유관표준，사선출유선도관내유두상종류82례，대상술병례진행HE형태관찰화면역조화검측，선용적일항유CK5/6、CK34pEl2、CK8、SMA、p63、CD10。결과82례IDPN환자중도관내유두상류(IDPMa)64례，유두상류반ADH화DCIS 12례，도관내유두상암(IDPC)6례。IDPN재형태학상표현위불동정도적상피세포화간질증생，이급계발병변등，저사사병조정현이상복잡적다양성。면역조직화학SMA균위강양성，각조간무명현차이；p63화CDlO적염색분포재IDPMa여IDPC량조간차이유통계학의의(균P<0.001)。세포각단백(CK5/6)염색현시량성병변적표체정양감상양성표체，재IDPC중표체명현감소혹결여，이자상비차이유통계학의의(P＜0.001)。결론 IDPN시일조조직학개변복잡적질병，응주의기진단표준적장악。기상피、세포각단백화선강상피표지물연합응용재해조복잡병변중유흔호적진단화감별진단개치。
Objective To observe breast intraductal papillary tumor (intraductal papillary neoplasms, IDPN) the morphology and the immune phenotype characteristics, and to explore its diagnosis. Methods According to the WHO classiifcation (2012) related standards, select 82 cases of breast intraductal papillary tumors, the above cases HE morphological observation and immunohistochemical detection, a resistance to choose has the CK5/6, CK34pEl2, CK8, SMA, about, CD10. Results 82 patients with IDPN feed tube papilloma (IDPMa) in 64 cases, papilloma with ADH, and 12 patients with DCIS are, intraductal papillary carcinoma (IDPC) 6 cases. IDPN on the morphology of different degree of epithelial and stromal hyperplasia, and secondary pathological changes, etc., these make the lesion presents complex diversity. Immunohistochemical SMA are strong positive, no signiifcant differences between groups;About and CD10 dyeing distribution in IDPMa with IDPC differences between the two groups was statistically signiifcant (P<0.001). Cytokeratin (CK5/6) staining showed that the expression of benign lesions inlaid with positive expression, expression is signiifcantly reduced or absent in the IDPC, compared the difference was statistically signiifcant (P<0.001). Conclusion IDPN histologic changes is a set of complex diseases, should pay attention to the diagnostic standard of mastery. Myoepithelial cell keratin and lumens of epithelial markers combined use of in the group complex lesions have great value in diagnosis and differential diagnosis.