富于脂质的乳腺癌17例临床病理分析

目的 对富于脂质的17例乳腺癌患者的临床病理特征进行回顾性分析.方法 采用雌激素受体（ER）、雄激素受体（PR）、原癌基因人类表皮生长因子受体2（HER-2）、细胞角蛋白5/6（CK5/6）、细胞角蛋白14（CK14）和p63免疫组化套餐检测抗体在富于脂质的乳腺癌中的表达水平,同时采用荧光原位杂交法检测HER-2基因扩增水平;并用电镜观测富于脂质的乳腺癌的超微结构;生存分析采用Kaplan-Meier和Cox 回归法,同时对其临床病理参数进行ROC检验.结果 免疫组化ER、CK5/6、CK14和P63反应呈阴性;PR和HER-2反应呈阳性;超微结构显示：在乳腺癌胞质内存在大量的脂滴.生存分析结果显示：年龄、组织学分级、淋巴结转移和HER-2表达水平与富于脂质的乳腺癌患者预后具有显著统计学意义（均P＜0.05或0.01）.结论 富于脂质的乳腺癌患者为HER-2呈过表达亚型;富于脂质的乳腺癌患者的生存情况可能与年龄、组织学分级、淋巴结转移和HER-2表达水平有关;提示：HER-2表达可作为预测富于脂质的乳腺癌的预后标记物.

Lipid-rich carcinoma of breast clinicopathological analysis of 17 cases

Objective We retrospectively analysed lipid-rich carcinomas of breast clinicopathological characteristic. Methods A panel of ER,PR,HER-2,CK5/6,CK14 and P63 were prepared for detection of lipid-rich carcinoma. FISH for HER-2 gene amplification and ultrastructure observation were also performed. Survival analysis was carried out by using of Kaplan-Meier and Cox Regression method. Receiver Operating Characteristic （ROC） test was also performed.Results PR,CK5/6, CK14 and P63 were negative. PR and HER-2 were positive. HER-2 gene amplification were presented in all included cases. Ultrastructure showed fat droplet in the cytoplasm. Statistically differences were detected among survival and age,histological grade,lymph node involvement and HER-2 expression respectively statistically differences were detected by using of Cox Regression simultaneously ROC test showed significant statistically differences（ all P〈0.05 or 0.01）. Conclusion Lipid-rich carcinoma was HER-2 over-expressing subtype of breast carcinomas. Survival of lipid-rich carcinoma might be associated with age, histological grade, lymph node involvement and HER-2. HER-2 expression might be as a marker for predicting the lipid-rich carcinoma of breast prognosis.