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目的探讨乳腺浸润性微乳头状癌(IMPC)的临床病理特征、免疫组化表达,并结合文献探讨其预后。方法对30例IMPC及39例浸润性导管癌(IDC)标本行组织病理和免疫组化检测,观察其组织形态改变、分析病理特征。结果 30例IMPC镜下特征性表现为肿瘤细胞呈桑椹状、微乳头状或小腺管样,癌巢与周围间质形成明显间隙。30例IMPC中,单纯IMPC者占43.3%,伴有浸润性导管癌及导管内癌者占56.7%;IMPC淋巴结转移率86.7%,显著高于IDC的56.4%;淋巴结转移个数比较差异显著;IMPC脉管瘤栓率90%,显著高于IDC的10.3%。免疫组化:IMPC(IDC)ER、PR、c-erb B-2、p53、Ki-67和CD44V6阳性率分别为90%(69.9%)、80%(56.4%)、66.7%(48.7%)、53.3%(53.9%)、63.3%(79.5%)和86.67%(94.9%);IMPC中ER、PR的阳性率显著高于IDC,两者比较差异显著(P<0.05);余免疫组化指标两者间比较不显著。结论 IMPC与IDC相比,前者具有较高的淋巴结转移率,预后相对较差,ER、PR高表达并不表示其预后较好;其高转移潜能与ER、PR、c-erb B-2、p53、Ki-67和CD44V6的阳性表达及肿瘤自身的大小无关,可能与微乳头状的生长方式有关。
Objective To investigate the clinicopathological features and immunohistochemical expression of IMPC in breast and to explore its prognosis with literature. Methods Thirty IMPC and 39 invasive ductal carcinoma (IDC) specimens were examined by histopathology and immunohistochemistry. Morphological changes were observed and their pathological features were analyzed. Results The characteristic features of 30 cases of IMPC were that the tumor cells were mulberry-like, micro-papillary or small duct-like, and the cancellous neoplasms formed obvious gaps with the surrounding interstitial. In 30 cases of IMPC, 43.3% of patients with IMPC, 56.7% of invasive ductal carcinoma and ductal carcinoma, IMPC lymph node metastasis rate was 86.7%, significantly higher than 56.4% of IDC; the number of lymph node metastasis was significantly different; The rate of IMPC vasculoma was 90%, significantly higher than 10.3% of IDC. Immunohistochemistry showed that the positive rates of ER, PR, c-erb B-2, p53, Ki-67 and CD44V6 in IMPC were 69.9%, 80.4% and 66.7% , 53.3% (53.9%), 63.3% (79.5%) and 86.67% (94.9%). The positive rates of ER and PR in IMPC were significantly higher than those in IDC (P <0.05) Indicators are less significant between the two. Conclusions Compared with IDC, IMPC has a higher rate of lymph node metastasis and a poorer prognosis. The high expression of ER and PR does not mean that its prognosis is good. The high metastatic potential of IMPC is correlated with the expression of ER, PR, c-erb B-2, The positive expression of p53, Ki-67 and CD44V6 have no relation with the size of the tumor itself, which may be related to the growth mode of micro-papilla.