摘要
目的探讨乳腺包裹性乳头状癌(encapsulated papillary carcinoma,EPC)的临床病理特征。方法回顾性分析17例乳腺EPC的临床病理资料和免疫组化染色结果(抗体包括p63、SMA、CK5/6、ER、PR、HER-2和Ki-67),获取随访患者预后信息。结果 17例EPC中女性16例,男性1例,平均年龄62岁。临床以乳腺肿块和乳头溢液为主要表现。肿瘤最大径1.5～5.5cm(平均2.9 cm),10例肉眼可见囊腔形成。镜下见肿瘤单发或多病灶聚集,肿瘤周围有纤维性包膜。多数EPC以乳头状结构为主,被覆柱状细胞。少数肿瘤伴有筛状、实体结构或以其为主。1例EPC伴有腋窝癌结节。EPC的周缘和乳头轴心均缺乏p63、SMA和CK5/6阳性染色的肌上皮层。肿瘤细胞ER、PR均(+),1例HER-2呈(),其余均(-)。Ki-67平均增殖指数为12%。10例随访患者均无局部复发、远处转移和死亡。结论缺乏周缘肌上皮层的EPC可被视为特殊的浸润癌亚型,其远期预后较好,可参照导管原位癌(ductal carcinoma in situ,DCIS)治疗标准进行临床治疗。
Purpose To elucidate the clinicopathologic features of encapsulated papillary carcinoma （EFC） of the breast. MethOdS The clinicopathologic features and immunohistochemical results of 17 cases of breast EPC were reviewed. The antibody used for immu- nohistochemical staining included p63, SMA, CK5/6, ER, PR, HER-2 and Ki-67. Follow-up data for the patients was got. Results Of the 17 EPC patients, 16 were females, with a mean age of 62 years. Palpable mass and nipple discharge were the most common symptoms. EPCs ranged in size from 1.5 to 5.5 cm （ mean 2. 9 era） , and 10 cases were cystic. Microscopic examination showed single or multiple lesions surrounded by a rim of fibrous connective tissue. The majority of EPCs demonstrated the classic features of a papilla- ry architecture lined by tall columnar epithelial cells. The minority presented a cribriform or solid glandular pattern. One patient had metastasis carcinoma in 1 axillary lymph node. Myoepithelial cell staining was negative for p63, SMA and CK5/6 within the tumor and at the periphery of the tumor. The tumor cells were positive for ER and PR. Only 1 case showed 2（ ＋ ） staining for HER-2, and the rest were negative, The average positive percentage for Ki-67 was 12%. Follow-up was available in 10 cases, and no patient had recur- rence, distant metastasis or death. Conclusions EPC lacking a peripheral layer of myoepithelial cells can be regarded as a special type of invasive carcinoma associated with better prognosis, and can be treated like the therapy of DCIS.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2012年第7期726-731,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
国家自然科学基金资助(81172536)
关键词
乳腺肿瘤
包裹性乳头状癌
免疫组织化学
breast neoplasms
encapsulated papillary carcinoma
immunohistochemistry
