乳腺导管内乳头状癌22例临床病理分析

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1、乳腺导管内乳头状癌22例临床病理分析【摘要】　　目的探讨乳腺导管内乳头状癌的临床病理学特征。方法复习22例乳腺导管内乳头状癌手术切除标本的病理切片并做相应的免疫组织化学染色，结合临床资料和组织学特点进行分析。结果眼观：包块边缘呈推挤状，直径1.5～4.2cm，切面灰粉色、实性、质脆。其中，6例标本切面上可见一囊内明显的乳头状成分，质脆易碎，边界不清。镜检：表现为乳头状结构，乳头被覆单一的腺上皮，≥90%的乳头完全缺乏肌上皮层，腺上皮单层或多层，与纤维轴心垂直，瘤细胞有不同程度的异型性。免疫组织化学：Actin、SMMHC、Calponin、p63、CD10、CK5/6显示≥90%

2、的乳头缺乏肌上皮层；乳腺导管上皮细胞AE1/AE3、CK7全部病例阳性、CEA18例病例阳性。结论乳腺导管内乳头状癌是一种罕见的乳腺低度恶性肿瘤，预后较好；诊断必须与乳腺导管内乳头状瘤鉴别，免疫组织化学在鉴别诊断中起关键作用。彻底切除肿瘤及其周围部分乳腺组织已属充分治疗。【关键词】乳腺导管内乳头状癌临床病理学特征免疫组织化学　　ABSTRACTObjectiveTodiscusstheclinicopathologicalfeaturesofintraductalpapillarycarcinomaofbreast.MethodsTheclinical,histologicala

3、ndimmunohistochemicaldataof22caseswithintraductalpapillarycarcinomaofbreastwerecollectedandanalyzed;relatedliteratureswerereviewed.12ResultsMacroscopicalstudyshowedthatmasseswerepushingtheiredgestothesurroundingtissuesandthediametersofthetumorswerefrom1.5cmto4.2cm;inthetumorsections,themasses

4、weregreypinkinsolidandcrisptexture;thepapillaryelementswereobviouslyobservedin6specimensandtheywereincrisptexturewithunclearborder;microscopicalstudyshowedthatpapillarystructurewasfoundinallthe22caseswithpapillarycoverofsimpleglandularepithelium;≧90%ofthepapillarywasincompletelackofmyoepithel

5、ialcelllayer,Thepapillarywascoveredwithmonolayerormultilayerglandularepitheliumwhichwasperpendiculartotheaxisofpapillaryandshowedvariableheteromorphism;immunohistochemicalstudyindicatedthatActin,SMMHC,Calponin,p63,CD10,CK5/6showedthat≧90%ofthepapillarymyoepitheliumwereabsentordiscontinuouswhi

6、leAE1/AE3andCK7in22casesandCEAin18caseswereallpositive.ConclusionsIntraductalpapillarycarcinomaofbreastisararelow-grademalignanttumor,itsprognosisisgenerallygood;attentionshouldbepaidtothedifferentialdiagnosisfromintraductalpapillomaofbreastandimmunohistochemistryplaysakeyroleinthedifferentia

7、ldiagnosis;thecompletetreatmentincludesthetotalremoveofthetumorandsurroundingbreasttissues.12　　KEYWORDSbreatintraductalpapillarycarcinomaofbreast　　　　clinicopathologicalfeaturesimmunohistochemistry　　乳腺导管内乳头状癌(IntraductalPapillaryCarcinomaofBre