乳腺实性乳头状癌73例临床病理诊断

目的对乳腺实性乳头状癌(solid papillary carcinoma,SPC)的临床病理特征和免疫表型特点、预后和鉴别诊断进行探讨。方法收集伴或不伴有浸润癌的SPC共73例,总结其临床资料、大体和组织病理特征,并行透射电镜观察及免疫组织化学EnVision法染色。选用抗体包括CK、肌上皮标记、神经内分泌标记、增殖标记Ki-67和ER、PR、c-erbB-2等。结果本病好发于老年女性,发病平均年龄64.7岁。肿瘤最常见的临床症状为乳腺肿块和乳头溢液。行腋窝淋巴结清扫术43例中有31例检出癌转移。镜检所有标本均见到实性乳头状病变,25例伴有黏液分泌。周边常可伴有导管内乳头状瘤。肿瘤细胞呈多边形、卵圆形或梭形,呈印戒样。胞质丰富,呈嗜酸性或细颗粒状。细胞核轻度或中度异型,51例核分裂象5个/10HPF。43例伴发浸润癌。肿瘤基底型CK表达呈阴性。平滑肌肌动蛋白SMA、p63在乳头轴心肌上皮的阳性率分别为91.8%、67.1%,在导管周围肌上皮的阳性率分别为91.8%,73.9%。CgA和Syn以及NSE阳性率分别为89.0%,86.3%,95.9%。Ki-67平均阳性指数为10.2%。73例行ER、PR染色的肿瘤大部分呈阳性,Her-2大部分呈阴性。电镜下可见到细胞内的神经内分泌颗粒。结论乳腺SPC是一种低度恶性的乳腺导管内癌,好发于老年女性,有其独特的组织形态、免疫组织化学特征,部分SPC与乳腺黏液癌和神经内分泌癌相关。随访资料显示SPC具有良好的预后。     

乳腺实性乳头状癌伴浸润性癌临床病理分析

目的探讨乳腺实性乳头状癌(solid papillary carcinoma,SPC)伴浸润性癌的临床病理特点、组织学特征和免疫表型。方法收集乳腺SPC伴浸润性癌8例,总结该组病变的临床资料,采用HE及免疫组化En Vision两步法染色检测组织病理学特征。结果乳腺SPC伴浸润性癌好发于老年女性,平均发病年龄55.5岁,其发生率约占SPC总病例的30%。肿瘤最常见的临床特征为乳腺肿块和乳头溢液,伴浸润癌常见的类型为乳腺非特殊类型癌和黏液癌,亦常伴神经内分泌分化。SPC伴浸润性癌时,浸润癌周边及其癌巢内肌上皮染色均为阴性。SPC与伴随的浸润癌区域ER、PR均阳性且阳性率较高(≥70%),HER-2均阴性,Ki-67增殖指数均≤10%。神经内分泌免疫组化标记Cg A及Syn均双阳性或单个阳性。结论 SPC可能是低级别乳头状导管原位癌的变异型,其具有进展为其他类型乳腺浸润性癌的潜能。SPC可能为伴神经内分泌分化乳腺黏液癌及非特殊类型癌原位癌阶段的病变。     

甲状腺乳头状癌RET、CK19、TG、Ki-67的表达

目的 研究甲状腺乳头状癌RET、CK19、TG、Ki-67蛋白表达特点及其临床意义。方法 应用免疫组织化学SP法检测RET、CK19、TG、Ki-67蛋白在30例甲状腺乳头状癌、10例结节性甲状腺肿和18例癌旁正常甲状腺中的表达。结果 RET、CK19在乳头状癌的阳性率（66．7％、83．3％）明显高于结节性甲状腺肿和正常甲状腺阳性率（7．1％、25．0％）,两者差异有显著性（P〈0．01）。乳头状癌组及良性病例组TG表达阳性率差异无显著性（P〉0．05）。96．7％的乳头状癌Ki-67阳性细胞数小于10％。结论 RET及CK19在甲状腺乳头状癌表达增加,具有一定的病理诊断价值。     

乳腺导管内乳头状肿瘤的形态学和免疫表型特征

目的观察乳腺导管内乳头状肿瘤（intraductal papillary neoplasms,IDPN）的形态学和免疫表型特征,并探讨其诊断。方法根据WHO分类（2003）和Tavassoli等（1999、2003）有关标准,筛选出乳腺导管内乳头状肿瘤41例,对上述病例进行HE形态观察和免疫组化检测,选用的一抗有CK5、CK34βE12、CK8、CD34、SMA、p63、CD10。结果（1）导管内乳头状瘤19例,镜检为扩张的导管或小管内含纤维-脉管轴心的乳头状病变,由腺（系）上皮和肌上皮覆盖轴心形成双层构型。其中16例伴腺（系）上皮普通性增生,2例〈10％的乳头覆盖上皮呈不典型增生（AH）改变。腺（系）上皮CK5 17例（89．5％）中～强阳性;CK34βE1216例（84．2％）中～强阳性。肌上皮SMA、p63、CD10均阳性。（2）非典犁导管内乳头状瘤4例,3例伴发于囊内乳头状癌,1例作为主要诊断。表现为≥10％而〈90％的乳头覆盖上皮呈AH改变。其AH区域CK5均阴性,3例CK34βE12阴性～弱阳性。（3）导管内乳头状癌21例,其中①2例仅表现为≥90％的乳头区肌上皮层完全缺乏;②1例仪表现为〉90％的乳头覆盖上皮呈低级导管原位癌（DCIS）样改变;③8例兼具上两种特征;④10例乳头覆盖上皮呈中～高级别DCIS样改变。符合②及③者CK5均阴性,CK34βE12 6例（66．7％）阴性～弱阳性;符合④者CK5、CK34βE12 8例（80％）均阴性～弱阳性。结论IDPN是一组良恶性不同的病变,各自的HE形态和免疫表型均有差异,应采用HE形态和免疫组化相结合的综合标准进行诊断。     

乳腺包裹性乳头状癌17例临床病理观察

目的探讨乳腺包裹性乳头状癌(encapsulated papillary carcinoma,EPC)的临床病理特征。方法回顾性分析17例乳腺EPC的临床病理资料和免疫组化染色结果(抗体包括p63、SMA、CK5/6、ER、PR、HER-2和Ki-67),获取随访患者预后信息。结果 17例EPC中女性16例,男性1例,平均年龄62岁。临床以乳腺肿块和乳头溢液为主要表现。肿瘤最大径1.5～5.5cm(平均2.9 cm),10例肉眼可见囊腔形成。镜下见肿瘤单发或多病灶聚集,肿瘤周围有纤维性包膜。多数EPC以乳头状结构为主,被覆柱状细胞。少数肿瘤伴有筛状、实体结构或以其为主。1例EPC伴有腋窝癌结节。EPC的周缘和乳头轴心均缺乏p63、SMA和CK5/6阳性染色的肌上皮层。肿瘤细胞ER、PR均(+),1例HER-2呈(),其余均(-)。Ki-67平均增殖指数为12%。10例随访患者均无局部复发、远处转移和死亡。结论缺乏周缘肌上皮层的EPC可被视为特殊的浸润癌亚型,其远期预后较好,可参照导管原位癌(ductal carcinoma in situ,DCIS)治疗标准进行临床治疗。     

基底型细胞角蛋白在乳腺周围型导管内乳头状肿瘤诊断中的应用

目的比较不同类型基底型细胞角蛋白（CK5/6、34βE12）在周围型乳头状肿瘤中的辅助诊断价值并结合CK8和肌上皮标记（p63、SMA）对乳头状肿瘤中的增生细胞成分进行初步分析。方法参照2003年WHO乳腺疾病分类的诊断标准,筛选出乳头状瘤伴普通型增生（UH）10例,伴不典型增生（AH）10例,导管内乳头状癌（IDPC）8例。所有病例均进行CK5/6、CK8、34βE12、p63和SMA免疫组化染色。结果乳头状瘤伴UH、AH及IDPC时,CK5/6在增生细胞中的阳性表达率分别为9/10、3/10、0/8;34βE12的阳性表达率分别为10/10、4/10、1/8。CK8在增生细胞中均为阳性,在乳头基底部和导管周围细胞中均为阴性。p63和SMA在增生细胞中均为阴性,在乳头基底部和导管周围细胞中有不同程度的阳性。结论基底型CK结合CK8和肌上皮标记有助于乳头状瘤是否伴UH、AH或IDPC的鉴别诊断。乳头状瘤伴上皮增生时有多种细胞成分参与,包括定向干细胞、腺中间细胞和腺终端细胞等,但未发现具有肌上皮特点的细胞参与其中。     

乳腺实性乳头状癌78例临床病理特征

目的探讨乳腺实性乳头状癌(solid papillary carcinoma, SPC)的临床病理学特征及预后。方法采用免疫组化Ventana法对78例乳腺SPC进行检测;采用FISH法对HER-2基因进行检测,并复习相关文献。结果 78例乳腺SPC患者均为女性,平均64.7岁,多以乳头溢液和(或)乳腺肿块就诊。78例中45例为原位SPC,33例伴浸润性癌。2例可见淋巴结转移。免疫表型:ER、PR均强阳性。70例神经内分泌标志物阳性,8例阴性。Ki-67增殖指数为3%～40%。11例原位SPC肌上皮表达缺失。78例患者HER-2基因检测均无扩增。78例患者随访4～64个月,平均17.6个月,均未见肿瘤复发。结论 SPC是一种好发于老年女性的低度恶性乳腺癌,常表达神经内分泌标志物,淋巴结转移率低,预后良好。     

乳腺分泌性癌的临床病理和免疫组织化学分析

目的 探讨乳腺分泌性癌的临床病理特征、免疫组织化学表达和特殊染色特点及其生物学意义。方法 分析3例乳腺分泌性癌的临床表现和病理特征;用黏液卡红（MC）和PAS/AB（Alcian blue）及淀粉酶消化后PAS/AB染色观察分泌物的性质,同时采用免疫组织化学ABC法检测ER、PR、Ki-67、p53、p63、c-erbB-2、S-100蛋白、CK7、SMA、CK1/3、EMA、CEA和CK34βE12在肿瘤细胞中的表达。结果 乳腺分泌性癌仅占同期全部活检乳腺癌的0.36%,平均年龄48.7岁。病理形态学的主要特点为癌细胞异型性较小,出现微囊性结构,癌细胞能产生大量分泌物等,对PAS/AB及黏液卡红染色呈现阳性反应。某些病例可以出现印戒样细胞,柱状上皮被覆的腺样结构,及间质广泛透明变性,癌细胞萎缩消失后形成的胶原硬化瘢痕,提示其高分泌活性和相对惰性的生长方式。尽管ER、PR阴性或仅局灶性表达,但预后相关基因p53和c-erbB-2全阴性或仅偶见弱表达,另外,Ki-67反映的增殖指数仅为6.3%,可能同其相对良好的组织形态和较好的预后有关。淋巴结均未见转移。结论 乳腺分泌性癌为一种少见的肿瘤,可发生于中老年女性,侵袭性和转移能力弱,预后良好。根据组织学表现,结合特染及免疫组化表达特点,可作出明确的病理诊断。     

乳腺黏液囊肿样病变临床病理特征分析

目的探讨乳腺黏液囊肿样病变的临床病理特征及其诊断和鉴别诊断。方法对9例乳腺黏液囊肿样病变进行临床病理分析。以SP法对细胞角蛋白AE1／AE3、平滑肌肌动蛋白（SMA）、p63、c-erbB-2和053进行免疫组织化学染色,组织化学为AB和PAS法染色。结果患者均为女性,年龄23-43岁（平均34岁）,乳腺均可触及肿物。肿物切面呈多囊性胶冻样。镜下可见多发性、充满黏液的囊肿,囊腔衬覆扁平-立方-柱状上皮,其中3例上皮有乳头状增生,1例有不典型增生。间质内可见黏液湖,其内无漂浮细胞。囊内及间质黏液呈AB及PAS染色阳性。囊肿衬覆上皮细胞及2例黏液湖内漂浮的上皮细胞团AE1／AE3阳性。囊肿上皮细胞外侧扁平肌上皮呈SMA、p63阳性。c-erbB-2和p53染色均阴性。结论乳腺黏液囊肿样病变是一种独立的良性病变,容易误诊,需与黏液癌等肿瘤进行鉴别。     

乳腺分泌脂质性癌临床病理分析

目的 探讨乳腺分泌脂质性癌(breast lipid-secreting carcinoma)临床病理特征.方法 对3例进行病理组织学观察、特殊染色PAS、AB染色和免疫组化标记ER、PR、Ki-67、c-erbB-2、p53等.结果 3例均为女性,年龄分别为44、54、50岁,均可触及乳腺肿块,肿瘤境界欠清楚,镜下肿瘤边缘呈浸润性生长,肿瘤主要由空泡状细胞即组织细胞样细胞和其它少量皮脂腺样细胞、大汗腺样细胞组成.AB、PAS染色阴性.免疫组化(SP法)瘤细胞示:ER、PR阴性、c-erbB-2、Ki-67、p53不同程度阳性.3例均术中快速切片诊断癌后,行乳腺改良根治手术.结论 乳腺分泌脂质性癌是一种相对少见,恶性度较高,预后较差的肿瘤,诊断主要依靠病理组织检查及特殊染色.免疫标记可帮鉴别诊断及判断预后.     

p53 and c-erbB-2 protein expression in breast carcinomas. An immunohistochemical study including correlations with receptor status, proliferation markers, and clinical stage in human breast cancer.

Receptor status, proliferative activity, loss of differentiation, inactivation of tumor suppressor genes, and overexpression of oncogenes are related events that may affect the prognosis of patients with breast cancer. Ninety-seven unselected breast carcinomas were immunostained for estrogen and progesterone receptors, Ki-67 proliferation-associated antigen, p53 tumor suppressor gene product (p53), and c-erbB-2 protein. Immunohistochemical results and clinical data were compared. Altered p53 expression (regarded as indirect indication of inactivating gene alterations) was found in 25.8% of cases and was associated with a high Ki-67 labeling index, high mitotic count, and high histologic grade, with c-erbB-2 overexpression, and with negative estrogen and progesterone receptor status. p53 immunostaining could be found also in cytologic samples and correlated with p53 immunoreactivity on frozen sections of the corresponding tumors. c-erbB-2 protein overexpression was seen in 24.7% of cases and was associated with p53 altered expression and negative receptor status. Double immunohistochemical staining showed p53 and c-erbB-2 immunoreactivity in the same cells. Median and mean +/- standard deviation Ki-67 labeling index values were 15 and 16.32 +/- 10.05, respectively. Ki-67 labeling index was correlated with high mitotic count and was positively associated with histologic grade, negative progesterone receptor status, and p53 expression. Estrogen receptor status was not associated with any histologic or clinical parameters, whereas progesterone receptor status was associated with grading. The direct relation of p53 protein alterations with c-erbB-2 overexpression may be interpreted in light of the multistep model of tumor progression. Cases with altered expression of both p53 and c-erbB-2 proteins could be interpreted as having lost one inhibitory control mechanism of cell proliferation and having gained one activator of the malignant potential. However, in comparing cases with the p53 + c-erbB-2 + phenotype with cases showing positivity for only one of these gene products, no association with higher stages was seen. Detection of p53 altered expression on cytologic samples of malignant tumors may have diagnostic relevance, and p53 immunostaining may prove to be an additional diagnostic criterion in cytologic diagnosis.     

Comparative study of non-functional islet cell tumors and pancreatic solid and papillary neoplasms: biological behavior and immunohistochemistry

Although non-functional islet cell tumor (NFICT) and solid and papillary neoplasm (SPN) share similar clinical and pathological features, the outcome of each is different. Because NFICT often follow a malignant course and SPN are usually benign, the correct differential diagnosis is very important. We investigated the clinical and pathological findings in 10 cases of NFICT and 12 cases of SPN, including immunohistochemical analysis for chromogranin, vimentin, neuron-specific enolase, somatostatin, alpha-1-antitrypsin, estrogen receptor, progesterone receptor, CD99, p21 and Ki-67. The current study shows that chromogranin is the most valuable marker in differentiating between the tumors (P < 0.01). In contrast to previous reports stating that SPN express the progesterone and/or estrogen receptors, which are absent in other pancreatic tumors, our results show that one-third of SPN were positive for the progesterone receptor. Downregulation of p21 was found more frequently in NFICT (40%) than SPN (17%). The mean value of the Ki-67 proliferation index for NFICT (2.77% +/- 2.53%) was significantly higher than that for SPN (0.94% +/- 0.89%; P = 0.043). These results are consistent with NFICT having more malignant behavior than SPN.     

乳腺基底细胞样癌的临床病理观察

目的 探讨乳腺基底细胞样癌(basal-like carcinoma,BLC))的临床病理特征、免疫表型特点及预后.方法 收集乳腺BLC 12例,总结其临床资料、大体及组织病理学特征,并进行免疫组化EnVision法染色.选用的抗体包括CK5/6、vimentin、CK8、ER、PR及c-erbB-2等.结果 本组患者均为女性,发病平均年龄40.4岁.12例乳腺BLC均为组织学Ⅲ级.肿瘤表现为无腺管的富于细胞的实性结构,周围有较少的纤维结缔组织间隔;大多数表现为推进式生长方式,周围有大量淋巴细胞浸润;排列呈实性巢状、片状、团块状及粗大带状结构伴有片状地图样坏死,肿瘤中央可出现无细胞结构的纤维瘢痕.肿瘤细胞胞质少呈合体状,核为圆形、卵圆形,胞核胞质比例高,核分裂象活跃.12例乳腺BLC的免疫表型均为ER、PR及c-erbB-2阴性,而CK5/6、CK8及vimentin阳性.结论 乳腺BLC是一种新的乳腺癌类型,具有独特的免疫组化特征、组织形态学特点及生物学特性,应作为一种独立的乳腺癌亚型加以认识.     

Aggressive papillary male breast carcinoma on fine-needle cytology sample

Papillary carcinoma (PC) is a histological variant of breast carcinoma that is more frequently observed in males than in females, showing the same cytological features in both sexes. PC is characterized by a low grade of malignancy and a generally favorable course. We describe a case of male breast PC (MPC) diagnosed by fine-needle cytology (FNC) in which some aggressive morphologically detectable features were associated with bland cytologic features of the tumor. FNC was performed on a 3 cm palpable mass of the left breast of a 55-yr-old male. FNC yielded abundant bloody material. Two smears were Diff-Quik and Papanicolaou stained, others were used for immunocytochemical assessment of estrogen, progesterone, c-erbB-2, and Ki-67; another was Feulgen stained for DNA ploidy. Smears were highly cellular, showing isolated cells and papillary structures. Cells showed tall and well-defined cytoplasm with a columnar aspect, light anisonucleosis, coarse chromatin, and small nucleoli. Immunoperoxidase staining demonstrated positivity for estrogen (50%), negativity for progesterone, intense positivity for c-erbB-2, with specific membrane staining and positivity for Ki-67 in more than 20% of the cells. DNA-ploidy showed an aneuploid histogram with 5c exceeding rate (5cER) of 59% and 2c deviation index (2cDI) of 29%. Subsequent surgical pathology examination confirmed the cytological diagnosis of papillary carcinoma; moreover, it revealed neoplastic endolymphatic thrombi and infiltrative border of the tumor that reached the thoracic wall. Cytological features can suggest diagnosis of MPC on FNC samples. Immunocytochemical evaluation of c-erbB-2 and Ki-67 and DNA ploidy evaluation on cytological smears might reveal a biological aggressiveness of PC despite the bland microscopic features of the tumor and this should influence the therapeutic procedure.     

伴有神经内分泌分化的乳腺梭形细胞癌

目的探讨乳腺伴有神经内分泌分化的梭形细胞癌的病理形态学和免疫表型特点及鉴别诊断。方法复习2500例乳腺癌切片,找出以梭形细胞占主要优势（〉80％）的癌5例,其中2例梭形细胞型导管内癌和3例梭形细胞型浸润癌。采用HE、阿辛蓝（AB）／PAS和网织染色,以及用癌胚抗原（CEA）、上皮膜抗原（EMA）、细胞角蛋白（CK7、3413E12、AE1／AE3）、神经元特异性烯醇化酶（NSE）、突触素、嗜铬蛋白（cg）A、Lue-7、波形蛋白,S-100、平滑肌肌动蛋白（SMA）、calponin、雌激素受体（ER）、孕激素受体（PR）、c—erbB-2、E-钙黏素、Ki-67、p53抗体进行免疫组织化学观察。其中4例有随访信息。结果患者平均年龄在68岁。镜下：5例癌细胞形态主要为长梭形的上皮样细胞,3例有少数胞质内空泡状细胞,4例可见散在AB阳性细胞。免疫组织化学5例均表达AE1／AE3、EMA、CEA、E-钙黏素和突触素,CK7有4例表达,NSE阳性3例,CgA和Lue7阳性2例,ER阳性4例,PR阳性2例,1例表达c-erbB-2,1例有灶状波形蛋白阳性。免疫组织化学结果显示2例梭形细胞型导管内癌和1例梭形细胞型浸润性癌是梭形细胞型的神经内分泌癌,另外2例梭形细胞型浸润性癌是伴有神经内分泌分化的化生性癌。随访3例存活（24～58个月）,1例27个月内死亡。结论上皮样梭形细胞和细胞内黏液的出现是乳腺伴有神经内分泌分化癌的一个形态学特点。梭形细胞神经内分泌型导管内癌需要和普通导管增生及导管内乳头状瘤鉴别。梭形细胞型的神经内分泌癌和伴神经内分泌分化的梭形细胞浸润性癌需要与梭形细胞肌上皮肿瘤、恶性黑色素瘤及某些软组织肿瘤鉴别。     

Apocrine ductal carcinoma in situ of the breast: histologic classification and expression of biologic markers

Apocrine ductal carcinoma in situ (ADCIS) has been called a special type of ductal carcinoma in situ (DCIS) because the histologic grading is considered difficult using the classification schemes that have been proposed for common DCIS. However, ADCIS encompasses a spectrum of lesions with different morphologic aspects ranging from minimally atypical to overtly malignant. To define a classification scheme for ADCIS, 35 cases (22 pure and 13 associated with invasive carcinoma) were selected on the basis of conventional morphology on hematoxylin and eosin (H&E)-stained sections. Each case was assigned to 1 of 3 histologic grades (low, intermediate, and high) based on nuclear morphology and the presence of necrosis. In addition, the expression of hormone receptors p53, bcl-2, c-erbB-2, and Ki-67 was evaluated by immunohistochemistry, and the DNA ploidy was determined by image cytometry. Fifteen cases were classified as high histologic grade, 10 as low histologic grade, and the other 10 as intermediate grade. All but 4 cases, irrespective of grade, had the same hormonal immunophenotype: androgen receptor positivity (97.1%) and estrogen receptor and progesterone receptor negativity (94.3% and 97.1% respectively). Twenty-one cases (61.8%) showed p53 expression, and 47.1% of the cases were positive for c-erbB-2. The median positivity for Ki-67 was 5.2%. ADCIS has a unique morphologic and hormonal profile, distinct from common DCIS, deserving a specific classification. The proposed classification scheme allows for categorization of ADCIS according to the most important morphologic features already seen in common DCIS, ie, nuclear grade and necrosis. The expression of biologic markers other than hormonal receptors and bcl2 in ADCIS seems in general to be similar to that in common DCIS. Ki-67 and c-erbB-2 are expressed more frequently in intermediate and high histologic grade ADCIS.     

乳腺原发性血管肉瘤的临床及病理学特征

目的探讨乳腺原发性血管肉瘤的临床及病理特点。方法复习5例乳腺原发性血管肉瘤切片,依据2003年WHO乳腺肿瘤组织学分类标准诊断和分级。采用第Ⅷ因子相关抗原、CD31、CD34、雌激素受体（ER）、孕激素受体（PR）、细胞角蛋白（cK）及c-erbB-2等抗体进行免疫组织化学SP法染色观察。结果5例患者均以乳腺无痛性肿块为首发症状,术前B超、钼靶检查缺乏特异性诊断。组织学呈多样性表现是乳腺血管肉瘤组织学形态特点。免疫组织化学染色显示,5例血管内皮相关抗原均呈阳性表达,ER、PR、CK及c—erbB-2均阴性。结论乳腺原发性血管肉瘤非常罕见,临床表现缺乏特异性,病理形态多样,诊断困难,血管内皮相关抗原均呈阳性表达对确诊有帮助。     

Histopathological subclassification of triple negative breast cancer using prognostic scoring system: five variables as candidates

We attempted to subclassify triple negative breast cancer (TNBC) cases into subgroups according to clinical outcome or prognosis of TNBC patients using archival specimens. We analyzed 102 Japanese cases of invasive TNBC who underwent surgery between January 1998 and December 2007. The clinicopathological factors and clinical information were retrospectively retrieved from reviewing the charts of the patients. Immunohistochemical staining was performed for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor 1 (EGFR1), CK5/6, CK14, Ki-67, and CD31 for microvessel density (MVD). Median follow-up time of the patients was 68.5 months. Multivariable analysis demonstrated that pathologic node status was the most significantly associated with relapse-free survival (RFS) and breast cancer-specific survival (BCSS) of these patients. Pathological tumor size, basal-like type, Ki-67 labeling index (LI) and MVD were also independently associated with RFS and BCSS. Based on these results, we devised the risk score system reflecting hazard ratios of these prognostic factors above. With this system, TNBC patients in this study were classified into three subgroups (low-risk group: score 0–3, intermediate-risk group: score 4–7 and high-risk group: score 8–10). The significant difference of RFS and BCSS was detected among these three different subgroups of the patients (p < 0.05). We propose the risk score system, which incorporated pathologic nodal status, size of the primary tumor, the presence or absence of basal-like features, Ki-67 LI, and MVD in order to predict postoperative clinical course of the Japanese TNBC patients.     

Sebaceous carcinoma of the eyelids: frequent expression of c-erbB-2 oncoprotein

Ocular sebaceous carcinoma (OSC) is an uncommon malignancy with a potential to recur and metastasize. Some characteristics of sebaceous carcinoma, such as female preponderance, shown in the present series during 11-year period at Korea Cancer Center Hospital, led us to study their hormone receptors and c-erbB-2 expression. c-erbB-2 overexpression was very common (83%) in OSC, and was not associated with pathologic findings or clinical outcome. Interestingly, estrogen and progesterone receptor was detected in 4 and 2 cases, respectively, suggesting a role of hormonal influence on this neoplasm. Immunohistochemical and clinicopathologic features of 18 cases of OSC in Korea are presented.