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1、乳腺大汗腺癌临床和病理学特征研究钱福永I邵牧民0广东医学院附属深圳市第三人民医院普通外科/广州屮医药人学深圳附属医院，广东深圳518000)【摘要】目的探讨乳腺大汗腺癌(AC)的临床和病理学特征。方法对4例乳腺大汗腺癌进行临床病理分析，采用过碘酸雪夫(PAS)、阿辛蓝(AB)染色及免疫组织化学A・P法检测GCDFPJ5、Mucin-1>Ki-67>雄激素受体(Androgenreceptor,AR)、雌激素受体(estrogenreceptor,ER)>C-erbB-2o结果4例均发生于中老年女性，因发现乳房包块就诊。3例位于右乳房外上象限，1例位于右乳
2、房内上象限，触及无痛性肿块，4例均于同侧腋窝触及肿大淋巴结。组织学4例均为高级核，其屮大汗腺导管原位癌(ADCIS)1例，ADCIS伴浸润性大汗腺癌(IAC)1例，IAC2例。镜下主要有2种形态：A型，胞质嗜伊红染的粗颗粒状;B型，胞质淡染，呈细粉尘颗粒状，如毛玻璃样。4例AC的PAS染色阳性，AB染色在ADCIS阴性，在IAC可有50%细胞阳性，并同时表达GCDPF-15,AR,Mucin-1及Ki・67；除1例外，ER均不表达。结论乳腺大汗腺癌的临床表现和大休形态与非乳腺大汗腺癌相似，多发生于单侧并且多数伴有同侧腋窝淋巴结转移，预后较好。其诊断主耍依
3、靠病理：①特征性的AC型细胞；②GCDPF-15阳性率高；③AR阳性率高，ER阳性率低。【关键词】乳腺肿瘤；大汗腺癌；免疫组织化学；雄激素受体Clinicandpathologicalstudyofapocrinecarcinomaofbreast•QIANFuyong,SHAOMu-ming.QIANFu-yongfSHAOMu-ming.('Dept,ofHepatobiliarySurgery,theAffiliatedShenzhenThirdPeoplezsHospitalofGuangdongMedicalCollege,2ShenzhenA
4、ffiliatedHospitalGuangzhouUniversityofTraditionalChineseMedicine,Shenzhen518000,China.E-mail:yinsdy2003@163.com[Abstract]AIMToinvestigatetheclinicopathologicalfeaturesandtheimmunohistochemicaphenotypeofapocrinecarcinoma(AC)ofbreast-METHODSTheclinicalandpathologicfeaturesof4caseso
5、fACinbreastwereinvestigated・Periodic-acid-Schiff(PAS),alcian-bluestainingwereperformed.Theimmunohistochemicalstudywasperformedbyapanelofantibodiesincludinggrosscysticdiseasefluidprotei1n15(GCDFP-15),Mucin-1,AR,ER,c-erb-2andKi-67.RESULTSAllfourcasesoccurredinmiddletooldagefemalepa
6、tients,complainingofmassinbreast.Masseswithoutpainwerefoundin3casesintheouterupperquadrantand1caseintheinnerupperquadrantofrightbreast,lymphnodemetastasesinipsilateralarmpitwerefoundin4cases.Histologically,4casesofapocrinecarcinomaswithhighnucleargradewereconfirmed,including1ADCI
7、S,1ADCISwithIACand2IAC.TwotypesofACcellswerenotedaccordingtothemorphologicofcytoplasm:Atype,neoplasticcellswithcopious,granulareosinophiliccytoplasm;Btype,carcinomacellswithfinelygranularpalecytoplasm,likefrostingglass-ACcellsof4casesshowedpositivityforPAS，ABisnegativeinADCISand5
8、0%positivityinIAC.4casesexpressedGCDFP-1
