乳腺微浸润癌的临床病理学特征及生物学特性

目的探讨乳腺微浸润癌（microinvasive carcinoma，MIC）的临床病理学特征及生物学特性和其病理诊断标准。方法回顾性研究40例MIC，按文献报道诊断标准分为两个亚型，并对病理学特征、分子生物学指标及预后进行比较。结果MIC占同期乳腺癌的1．5％，乳腺钼靶拍片85．0％的病例（34例／40例）显示不同程度的泥沙样钙化。粉刺型和高核分级的导管内癌更易形成间质浸润。淋巴结转移2．5％（1例／40例）。31例平均8个月随访显示无复发及转移。两亚型各指标比较结果差异均无显著性。结论MIC是一种少见、淋巴结转移率低、预后较好的恶性肿瘤。建议诊断标准：单个浸润灶时，最大径应〈2mm；出现几个浸润灶时，其中单个浸润灶的最大径应〈1mm，且几个浸润灶面积总和不应超过整个肿瘤组织面积的10％。

Biological and clinicopathological characteristics in microinvasive carcinoma of breast

Purpose To investigate the biological and clinicopathologic characteristics in microinvasive carcinoma(MIC) of the breast, and to provide a more reasonable diagnosis criterion. Methods 40 cases MIC were retrospectively analyzed and divided into two subtypes based on the reported diagnostic criteria, and then the histopathologic characteristics, molecular biological markers and biological behavior were analyzed and compared between the two subtypes. Results IMC accounted for 1.4% of breast carcinoma and 85% cases demonstrated microcalcification on mammographaphy. It was found that high nuclear grade and comedo DCIS were more aggressive and more common with microinvasion. Only one case developed lymph node metastases in the 40 cases. After median follow-up of 8 months, no one case showed recurrence or distance metastases. The two subtypes of MIC had no significant difference in the clinicopathologic parameters. Conclusions Microinvasive carcinoma of the breast is rare, and has the low rate of lymph node metastases and better prognosis.The diagnosis criteria should be that a single focus no larger than 2 mm, or multiple focus each less than or equal to 1mm in the greatest dimension, but the total area is no more than 10% of that of the tumor.