临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
9期
1637-1642
,共6页
乳腺癌%印戒细胞分化%临床病理特征%免疫表型%预后
乳腺癌%印戒細胞分化%臨床病理特徵%免疫錶型%預後
유선암%인계세포분화%림상병리특정%면역표형%예후
breast cancer%signet-ring cell differentiation%clinicopathological characteristics%immunophenotype%prognosis
目的：探讨6例伴印戒细胞分化的原发性乳腺癌的临床病理特征、免疫表型、诊断和鉴别诊断。方法：对6例伴印戒细胞分化的原发性乳腺癌的临床特点、病理学特征、免疫组化特点等进行分析，并复习相关文献。结果：6例患者均为女性，平均年龄45岁，均因发现乳腺肿块而就诊。镜下肿瘤细胞呈印戒状，胞浆内可见大空泡，核被挤于一侧，呈弥漫性、巢状及条索状分布于乳腺纤维间质中。6例中有3例为单纯型的印戒细胞癌，3例合并其他类型浸润性乳腺癌。免疫组化显示：6例中有5例肿瘤细胞ER为阳性，3例E-Cadherin阳性。6例中Her-2(3+)1例、Her-2(2+)2例、Her-2(1+)3例。6例中5例均有腋窝淋巴结转移。5例行乳腺改良根治切除术，1例行单纯乳腺切除术。2例分别于术后3年及4年发生远处转移。6例至随访结束均存活。结论：伴印戒细胞分化的乳腺癌的病理诊断主要依赖于其特征性组织学表现与免疫组化染色特点。与其他类型乳腺浸润性癌相比，伴印戒细胞分化的乳腺癌更具侵袭性，预后较差。
目的：探討6例伴印戒細胞分化的原髮性乳腺癌的臨床病理特徵、免疫錶型、診斷和鑒彆診斷。方法：對6例伴印戒細胞分化的原髮性乳腺癌的臨床特點、病理學特徵、免疫組化特點等進行分析，併複習相關文獻。結果：6例患者均為女性，平均年齡45歲，均因髮現乳腺腫塊而就診。鏡下腫瘤細胞呈印戒狀，胞漿內可見大空泡，覈被擠于一側，呈瀰漫性、巢狀及條索狀分佈于乳腺纖維間質中。6例中有3例為單純型的印戒細胞癌，3例閤併其他類型浸潤性乳腺癌。免疫組化顯示：6例中有5例腫瘤細胞ER為暘性，3例E-Cadherin暘性。6例中Her-2(3+)1例、Her-2(2+)2例、Her-2(1+)3例。6例中5例均有腋窩淋巴結轉移。5例行乳腺改良根治切除術，1例行單純乳腺切除術。2例分彆于術後3年及4年髮生遠處轉移。6例至隨訪結束均存活。結論：伴印戒細胞分化的乳腺癌的病理診斷主要依賴于其特徵性組織學錶現與免疫組化染色特點。與其他類型乳腺浸潤性癌相比，伴印戒細胞分化的乳腺癌更具侵襲性，預後較差。
목적：탐토6례반인계세포분화적원발성유선암적림상병리특정、면역표형、진단화감별진단。방법：대6례반인계세포분화적원발성유선암적림상특점、병이학특정、면역조화특점등진행분석，병복습상관문헌。결과：6례환자균위녀성，평균년령45세，균인발현유선종괴이취진。경하종류세포정인계상，포장내가견대공포，핵피제우일측，정미만성、소상급조색상분포우유선섬유간질중。6례중유3례위단순형적인계세포암，3례합병기타류형침윤성유선암。면역조화현시：6례중유5례종류세포ER위양성，3례E-Cadherin양성。6례중Her-2(3+)1례、Her-2(2+)2례、Her-2(1+)3례。6례중5례균유액와림파결전이。5례행유선개량근치절제술，1례행단순유선절제술。2례분별우술후3년급4년발생원처전이。6례지수방결속균존활。결론：반인계세포분화적유선암적병리진단주요의뢰우기특정성조직학표현여면역조화염색특점。여기타류형유선침윤성암상비，반인계세포분화적유선암경구침습성，예후교차。
Objective:To explore the clinicopathological characteristics of 6 cases of primary breast carcinoma with signet-ring cell differentiation. Methods:Six cases of primary breast carcinoma with signet-ring cell differentiation were studied with histopathological and immunohistochemical staining, and its clinical and pathological ifndings were analyzed with review of the literature. Results:All the patients were female, with the average age of 45 years. All the patients presented with a lump in the breast. hTe histological examination of the neoplastic cells showed that the majority of tumor cells showed features of signet-ring cells. hTey were small and round, scattered or funicular distribution, and with large intracytoplasmic mucin compressing the nuclei toward one pole of the cell. hTree of the six cases were pure signet-ring cell carcinoma, and three were mixed with other subtypes of invasive breast carcinoma. Immunohistochemically, the tumor cells in 5 of the 6 cases were focally positive for ER, and 3 of 6 cases were focally positive for E-Cadherin. One of 6 cases have the positive status of Her-2 (3+), 2 of them with Her-2 (2+), and 3 of them with Her-2 (1+). Five of the six cases had lymph node metastases. Five cases were treated with modiifed radical mastectomy, and 1 case with mastectomy alone. Two of the six cases occurred distant metastasis atfer 3 and 4 years respectively. All the cases survived atfer the last follow-Up. Conclusion:hTe diagnosis of primary breast carcinoma with signet-ring cell differentiation is based on distinctive histopathology and immunohistochemical staining. Compared with other subtypes of invasive breast carcinoma, primary breast carcinoma with signet-ring cell differentiation exhibits higher invasiveness and worse prognosis.
