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目的探讨乳腺实性乳头状癌(SPC)临床病理特征。方法回顾性观察和分析22例乳腺实性乳头状癌的临床和病理组织学特点,选用ER、PR、p53、Ki-67、cerbB-2,S-100、p63,CgA、E-cadherin和CD31等抗体进行免疫组化标记并随诊患者。结果 22例均为女性,平均年龄68.63岁,占我科同期切除乳腺癌的0.97%。大体观察肿瘤界限清楚,均可见纤维性包膜。镜下为缺乏显著异型性的实性细胞巢,局部可见乳头,其中21例纤维血管周围可见黏液;8例合并黏液癌,但其比例<40%;癌细胞巢周边均缺乏肌上皮标记,瘤细胞比较一致,部分细胞胞质中含黏液;行腋窝淋巴结清扫的20例均无腋窝淋巴结转移;13例随访3～110月(平均39.8个月),无1例复发和转移。免疫组化显示瘤细胞ER、PR强(+),仅有2例c-erbB-2(+),p53、S-100、p63、CgA均(-),Ki-67指数平均8%(1%～20%)。结论乳腺实性乳头状癌是一少见病理类型,好发于老年女性,具有其独特的病理形态和免疫组化表达,即使伴有浸润切除后也不易转移和复发,预后良好。
Objective To investigate the clinicopathological features of breast solid papillary carcinoma (SPC). Methods The clinical and histopathological characteristics of 22 cases of solid papillary carcinoma of the breast were retrospectively reviewed. The expressions of ER, PR, p53, Ki-67, cerbB-2, S-100, p63, CgA, E-cadherin and CD31 Antibodies and other immunohistochemical markers and follow-up patients. Results All the 22 cases were female, with an average age of 68.63 years old, accounting for 0.97% of the resected breast cancer in our department. General observation of tumor boundaries clear, can be seen fibrous capsule. In the absence of significant atypia of the solid cell nests, local visible nipples, of which 21 cases of mucus seen around the fibrovascular; 8 cases of mucinous carcinoma, but the proportion of <40%; cancer nest around the nest lack of myoepithelial markers, tumor The cells were consistent, some of the cytoplasm contained mucus; axillary lymph node dissection in 20 cases were no axillary lymph node metastasis; 13 cases were followed up for 3 to 110 months (average 39.8 months), no recurrence and metastasis in 1 case. Immunohistochemistry showed that there were only 2 cases of c-erbB-2 (+), p53, S-100, p63 and CgA % ~ 20%). Conclusion Solid papillary carcinoma of the breast is a rare pathological type that occurs in elderly women. It has its unique pathological morphology and immunohistochemical expression. It is not likely to metastasize and recur even after resection of infiltration. The prognosis is good.