乳腺分叶状囊肉瘤21例临床病理研究

目的：对21例乳腺分叶状囊肉瘤进行临床病理研究。方法：用病理组织学方法，对1990－2000年有完整资料的乳腺分叶状囊肉瘤材料进行常规切片和临床资料分析。结果：21例中平均年龄为40岁，右侧多于左侧，临床确诊主要依靠病理组织的检查。病理学诊断标准主要为细胞的异形性、坏死、病理性核分裂和包膜侵犯。结论：乳腺分叶状囊肉瘤的确诊主要靠病理诊断，按瘤细胞的不同分化，决定其恶性程度，临床目前主要是以手术切除为主要治疗方法。对分化较好和年轻女性手术时要考虑到保留乳房的问题，对分化差或复发的病人可考虑做单纯乳房连同胸大肌筋膜切除或改良根治手术。由于乳腺分叶状囊肉瘤淋巴转移少见，故保留腋下淋巴结对患局部免疫功能有帮助。

Clinical pathology analysis of 21 cases of breast cystosarcoma phyllodes

Objective To find out the pathology character of breast cystosarcoma phyllodes. Methods Retrospective analysis and pathology examination were made on 21 cases of breast cystosarcoma phyllodes. Results The mean age of 21 patients was 40. cystosarcoma phyllodes found in right breast were more than that of left breast. Pathology examination of tunor tissue provided most evidence for final diagnosis. Pathology standard of diagnisis was heteromorpha, necrosis, pathologic mitosis and encroach on envelope. Conclusions Pathology examination is the most important method to diagnose a cystosarcoma phyllodes. The malignant degree were decided on the differentiation of tumor cell.Resection of tumor is still the most effective treatment for cystosarcoma phyllodes. But for the young patients with well differentiated cystosarcoma phyllodes, reserve of breast should be considered. Resection of breast combined with pectoralismajor fasciae or modified radical operation should be considered for patients with bad differentiation or recurrence. Lymphatic metastasis is rarely found , so the reserve of oxter lymph nodes should be helpful to keep local immunological function.