摘要
目的分析讨论乳腺浸润性微乳头状癌（IMPC）的临床病理特征，为治疗方案的个体化和预后判断提供依据。方法：分析该科诊治的8例乳腺浸润性微乳头状癌的临床病理及免疫组化等表现，结合文献探讨其临床病理特征。结果：8例病例均为女性，平均年龄49岁（37～58岁），肿瘤平均最大直径3．4 cm（2—4．8 cm），主要症状均为乳腺肿块。B超均发现肿块，肿块不规则，边界不清，低回声；肿瘤周围明显血流信号6例；4例肿块伴点状钙化；腋淋巴结肿大5例，术后均证实淋巴结转移。钼靶发现肿块7例，肿块主要特征为不规则，边界不清或毛刺，伴细小钙化5例，1例仅发现细小钙化，可见肿大淋巴结5例。8例中ER阳性5例，PR阳性3例，4例HER-2过表达。6例肿瘤细胞表达E—cadherin，但面对基质方向细胞膜无表达。Ki67均在14％以上。术后随访6月～5年，2例局部复发，平均复发时间9月。结论：IMPC具有较强侵袭性、高淋巴转移、局部复发，其特殊临床病理特性是主要原因，结合辅助化疗、放疗、内分泌治疗和靶向治疗的综合治疗很必要。
Objective To analyze the clinicopathological characteristics of breast invasive micropapillary carcinoma （IMPC）, andprovide a basis for making individualized therapeutic schedule and predicting prognosis. Methods： The clinicopathological and immunohisto-chemical manifestations of eight patients with breast IMPC diagnosed and treated in the hospital were analyzed, the clinicopathological characteristics were studied combing with literature review. Results： All the eight patients were female, the mean age was 49 years （37 - 58years old）, the largest mean diameter of IMPC was 3.4 cm （2 -4. 8 cm）, the main symptom was breast mass; all the masses were detectedby ultrasonography, the shape was irregular, the boundary was not clear, and the echo was low; 6 patients were found with obvious bloodflow signals adjuvant to masses; 4 patients were found with punctate calcification, 5 patients were found with axillary lymph node enlargement, which were confirmed as lymph node metastasis after surgery; 7 patients were found with IMPC by Mo - target mammography, themain characteristics of masses were irregular shape, unclear boundary or with rags ; 5 patients were found with small calcification, one patientwas only found with small calcification; 5 patients were found with lymphadenectasis; among 8 patients, 5 patients were found with positiveestrogen receptor, 3 patients were found with positive progestogen receptor and 4 patients were found with over - expression of HER - 2 ; E -cadherin expressed in tumor cells of 6 patients, but it didnt express in stromal cell membrane; the expression rate of Ki67 was more than14% ; the patients were followed up from 6 months to 5 years, local recurrence occurred in two patients, the mean recurrence time was 9months. Conclusion： IMPC has the characteristics of high invasion, high lymph node metastasis and local recurrence; the specific clinico-pathological characteristics are the main causes, comprehensive therapy of assisted chemotherapy, radiotherapy, endocrine therapy and targettherapy is necessary.
出处
《中国妇幼保健》
CAS
北大核心
2014年第18期2857-2859,共3页
Maternal and Child Health Care of China
基金
四川省医药卫生科技计划项目〔2010ZB108〕
关键词
浸润性微乳头状癌
乳腺癌
诊断
Invasive micropapillary carcinoma
Breast carcinoma
Diagnosis
