文章摘要

24例乳腺黏液癌临床病理分析

作者: 1,2江文辉, 1胡丹, 1许春伟, 1力超, 1卢建平, 1何时, 2龙联文, 1陈刚
1 福建医科大学教学医院福建省肿瘤医院病理科,福州 350014
2 福建龙岩市第二医院病理科,福建 龙岩 364000
通讯: 胡丹 Email: 54511322@qq.com
陈刚 Email: naichengang@126.com
DOI: 10.3978/j.issn.2095-6959.2016.10.009
基金: 福建省自然基金项目, 2016J01508 福建省卫生厅青年基金课题项目, 2009-1-23

摘要

目的:探讨乳腺黏液癌的临床病理特点,临床进展及预后。方法:对24例乳腺黏液癌进行病理学形态观察,并采用Max Vision法进行免疫组织化学雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、Her-2、Ki-67染色,对其进行随访和分析并回顾相关文献。结果:18例单纯型乳腺黏液癌,其中1例伴有微乳头结构的乳腺黏液癌,6例混合型。免疫组织化学肿瘤细胞22例ER阳性,19例PR阳性,1例混合型黏液癌HER-2阳性,单纯型黏液癌HER-2均阴性,单纯型乳腺黏液癌和混合型乳腺黏液癌两者具有统计学意义(P<0.05)。结论:乳腺单纯型黏液癌特征是细胞巢漂浮在黏液湖中,并由富含毛细血管的纤维分割。细胞团大小和形态各异,核异型性不明显,ER、PR阳性,HER-2阴性。单纯型乳腺黏液癌(pure mucinous carcinoma,PMCs)生长缓慢,转移率低,可以行保乳手术。伴有微小乳头结构的乳腺黏液癌(mucinous micropapillary carcinoma,MUMPC)与混合型乳腺黏液癌易发生转移,建议行乳腺改良根治手术,术后辅助放化疗。
关键词: 乳腺肿瘤 黏液癌 免疫组织化学 诊断 鉴别诊断

Clinicopathologic features of 24 cases of breast mucinous carcinoma

Authors: 1,2JIANG Wenhui, 1HU Dan, 1XU Chunwei, 1LI Chao, 1LU Jianping, 1HE Shi, 2LONG Lianwen, 1CHEN Gang
1 Department of Pathology, Fujian Provincial Cancer Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014
2 Department of Pathology, the Second Hospital of Longyan, Longyan Fujian 364000, China

CorrespondingAuthor: HU Dan Email: 54511322@qq.com

DOI: 10.3978/j.issn.2095-6959.2016.10.009

Abstract

Objective: To investigate the clinical features, clinical progress and prognosis of mucinous carcinoma of the breast (PMC). Methods: 24 cases of mucinous carcinoma of the breast was analyzed by detailed histopathologic observation and immunohistochemical staining for estrogen receptor (ER), progesterone receptor (PR), HER-2, Ki-67, using Max Vision method. The follow up and clinical data were analyzed. Results: Eighteen cases were simple type of breast mucinous carcinoma, 1 cases of breast mucinous carcinoma with micro nipple structure, 6 cases were mixed type. Twenty-two cases were positive for ER, nineteen cases were positive for PR except one case of mixed type mucinous carcinoma were positive for HER-2. All cases of pure mucinous carcinoma were negative, there were statistically significant between PMC and MMC (P<0.05). Conclusion: The simple mucinous carcinoma of the breast which is composed of capillary rich fiber is characterized by the floating of the cell nests in the mucous lake. The sizes of the cell clusters are different, and the nuclei were not irregular, express for ER, PR positive and HER-2 negative. MUMPC of nuclear are pleomorphism and hobnail cells with the Her-2 positive. PMC with slow growth and low metastasis rate can be performed with breast conserving surgery. Mucinous micropapillary carcinoma of the breast (MUMPC) and mixed type of mucinous carcinoma of the breast are easy to be transferred. Modified radical mastectomy with postoperative radiotherapy and chemotherapy should be needed.

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