基层医学论坛
基層醫學論罈
기층의학론단
The Medical Forum
2015年
30期
4242-4244
,共3页
乳腺肿瘤%实性乳头状癌%临床特征%病理分析
乳腺腫瘤%實性乳頭狀癌%臨床特徵%病理分析
유선종류%실성유두상암%림상특정%병리분석
Breast neoplasms%Solid papillary carcinoma%Clinical characteristics%Pathological diagnosis
目的：探讨乳腺实性乳头状癌（solid papillary carcinoma，SPC）的临床病理特征、免疫表型特点、鉴别诊断及预后。方法对4例SPC患者进行常规病理检查、免疫组化标记，并结合临床资料及相关文献进行分析。结果4例SPC患者均为女性，发病年龄33岁~67岁，临床表现为乳头溢血1例，发现乳腺肿块3例。镜下见肿瘤被厚纤维分隔成巢状，肿瘤细胞巢内见纤细的纤维血管轴心，轴心周围细胞成栅栏状或围绕血管呈菊形团结构。瘤细胞轻度异型，可见细胞内、外黏液，核分裂象少见。免疫组化瘤细胞均表达ER、PR、Syn、CgA，瘤巢周围肌上皮CK5/6、SMA、P63散在阳性表达或不表达，乳头轴心肌上皮CK5/6、SMA、P63见阳性表达；Ki-67均为低表达（平均阳性指数2%）；C-erBb-2均为阴性。结论 SPC好发于老年女性，临床上多表现为乳头溢血或乳腺肿块，有独特的组织学及免疫组织化学特点，预后较好。
目的：探討乳腺實性乳頭狀癌（solid papillary carcinoma，SPC）的臨床病理特徵、免疫錶型特點、鑒彆診斷及預後。方法對4例SPC患者進行常規病理檢查、免疫組化標記，併結閤臨床資料及相關文獻進行分析。結果4例SPC患者均為女性，髮病年齡33歲~67歲，臨床錶現為乳頭溢血1例，髮現乳腺腫塊3例。鏡下見腫瘤被厚纖維分隔成巢狀，腫瘤細胞巢內見纖細的纖維血管軸心，軸心週圍細胞成柵欄狀或圍繞血管呈菊形糰結構。瘤細胞輕度異型，可見細胞內、外黏液，覈分裂象少見。免疫組化瘤細胞均錶達ER、PR、Syn、CgA，瘤巢週圍肌上皮CK5/6、SMA、P63散在暘性錶達或不錶達，乳頭軸心肌上皮CK5/6、SMA、P63見暘性錶達；Ki-67均為低錶達（平均暘性指數2%）；C-erBb-2均為陰性。結論 SPC好髮于老年女性，臨床上多錶現為乳頭溢血或乳腺腫塊，有獨特的組織學及免疫組織化學特點，預後較好。
목적：탐토유선실성유두상암（solid papillary carcinoma，SPC）적림상병리특정、면역표형특점、감별진단급예후。방법대4례SPC환자진행상규병리검사、면역조화표기，병결합림상자료급상관문헌진행분석。결과4례SPC환자균위녀성，발병년령33세~67세，림상표현위유두일혈1례，발현유선종괴3례。경하견종류피후섬유분격성소상，종류세포소내견섬세적섬유혈관축심，축심주위세포성책란상혹위요혈관정국형단결구。류세포경도이형，가견세포내、외점액，핵분렬상소견。면역조화류세포균표체ER、PR、Syn、CgA，류소주위기상피CK5/6、SMA、P63산재양성표체혹불표체，유두축심기상피CK5/6、SMA、P63견양성표체；Ki-67균위저표체（평균양성지수2%）；C-erBb-2균위음성。결론 SPC호발우노년녀성，림상상다표현위유두일혈혹유선종괴，유독특적조직학급면역조직화학특점，예후교호。
ObjectiveTo explore the clinicopathologic features,immunophenotype,antidiastole and prognosis of solid papillary carcinoma(SPC)of breast.Methods4 patients with SPC were treated by routine pathological examination,immunohistochemical markers,and clinical data,related literature were analyzed.ResultsThe 4 patients were female,aged from33 to 67 years,the clinical manifestations of 1 cases of nipple blood dischargeand 3 cases of breast lumps were found. Microscopically,the tumor was divided into nests by thick fibers and that fine delicate fibrovascular septa were discovered amid the solid proliferation. The tumor cells were mild,mucus secretion were seen inside and outside the cell. Immunohistochemistry,the tumor cells showed the expression of ER,PR,Syn,CgA.CK5/6,SMA,P63 expression were seen on myoepithelial scattered positive or not around the tumor nests,but positive on myoepithelial of the papilla axis.The average of Ki-67 index of tumor cells was 2%.All case were negative for c-erbB-2.ConclusionSPC is predominantly found in elderly females with distinctive pathological features and immunophenotype,the clinical manifestations were nipple blood discharge or finding breast lumps,the prognosis is good.
