浸润性微乳头状癌与浸润性导管癌免疫组化及临床病理特征的比较

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目的:研究乳腺浸润性微乳头状癌(IMPC)的临床病理特点及与ER、PR、c-erbB-2和E-cadherin的表达关系。方法:回顾性分析608例乳腺癌患者临床资料,筛选IMPC,观察其临床病理特点,SP法检测ER、PR、c-erbB-2及E-cadherin的表达,并与浸润性导管癌(IDC)比较。结果:IMPC在乳腺癌中的发生率为4.9%(30/608),组织形态表现为缺乏纤维血管轴心的微乳头或管泡状细胞簇被纤细的胶原纤维间质分隔,两者之间有一个透明、扩张的腔隙,淋巴结转移灶癌组织保留着微乳头状的生长方式。IMPC淋巴结转移90.0%显著高于IDC的53.3%,肿瘤最大径>2cm者83.3%较IDC的53.3%明显多。IMPC与IDC的ER、PR、c-erbB-2表达率分别为46.7%和56.7%,53.3%和43.3%,40.0%和60.0%,两者差异无统计学意义。IMPC的E-cadherin表达为90.0%,明显高于IDC组的63.3%,且主要表达于肿瘤细胞间连接面及管腔内的细胞膜,而微乳头朝向间质面的细胞膜则表达减弱或消失。结论:IMPC是乳腺癌中的少见类型,与IDC相比,具有较高的淋巴结转移率,其高转移潜能可能与微乳头状的生长方式及E-cadherin高表达及特定的表达方式有关,而与ER、PR、c-erbB-2表达无关。 Objective: To investigate the clinicopathological features and the expression of ER, PR, c-erbB-2 and E-cadherin in breast invasive micro-papillary carcinoma (IMPC). Methods: The clinical data of 608 patients with breast cancer were retrospectively analyzed. The IMPC were screened and the clinicopathological characteristics were observed. The expressions of ER, PR, c-erbB-2 and E-cadherin were detected by SP method. Compare RESULTS: The incidence of IMPC in breast cancer was 4.9% (30/608). The morphology of IMPC was micro-papilla or vacuolar cell clusters lacking fibrovascular axes separated by slender collagen fibers, There is a transparent, expanding lacunar, lymph node metastasis of cancer tissue retained micro-papillary growth. The incidence of lymph node metastasis in IMPC was significantly higher than that in IDC by 90.0% and 83.3%, respectively. The maximum diameter of tumor> 2cm was significantly higher than 53.3% of IDC. The expression rates of ER, PR and c-erbB-2 in IMPC and IDC were 46.7% and 56.7%, 53.3% and 43.3%, 40.0% and 60.0% respectively, with no significant difference between the two groups. The expression of E-cadherin in IMPC was 90.0%, which was significantly higher than that in IDC group (63.3%). The expression of E-cadherin in IMPC was mainly expressed in the cell membrane in the junctional and intraluminal tumor cells. CONCLUSION: IMPC is a rare type in breast cancer. Compared with IDC, IMPC has a high rate of lymph node metastasis. Its high metastatic potential may be related to micropapillary growth pattern and high expression of E-cadherin, as well as specific expression patterns. However, Not related to ER, PR, c-erbB-2 expression.
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