Prognostic factors in primary mucinous breast carcinoma

Two hundred seven mucinous breast carcinomas were morphologically classified into two different groups: pure mucinous carcinomas consisting only of areas with small epithelial islands of solid tumor floating in abundant extracellular mucin, and mixed carcinomas where the tumor contains large areas of mucin, as well as areas with infiltrating carcinoma devoid of extracellular mucin. Of the 207 tumors, 95 were of the pure type and 112 of the mixed type. The pure and mixed carcinomas differed significantly with respect to a number of prognostic factors, the most important of which was lymph node status. Patients with pure mucinous carcinomas had significantly fewer lymph node metastases at the time of primary operation (P = 0.0001) and a significantly longer recurrence-free survival (P = 0.03) than patients with mixed carcinomas. Patients with mixed carcinomas closely resembled patients with infiltrating ductal carcinomas not otherwise specified (NOS) with respect to both lymph node status and recurrence-free survival. In multivariate analysis, the single most important factor for predicting recurrence-free survival among the 207 patients was lymph node status. However, of 94 pure carcinomas, only 6 had lymph node metastases at the time of mastectomy. A detailed morphologic analysis demonstrated that two of these six cases were incorrectly diagnosed as being pure mucinous carcinomas--they were actually of the mixed type. In another two of these cases, the metastases originated from a co-existent infiltrating ductal carcinoma. Thus, metastases to the regional lymph nodes were observed in only two cases of pure mucinous carcinomas. It is concluded that the biologic behavior of the pure mucinous carcinomas differs from that of both the mixed carcinomas and infiltrating ductal carcinomas NOS. Thus, a new definition is suggested, in which a mucinous carcinoma is classified as such only if it is a pure carcinoma, and mixed mucinous carcinomas are classified according to the component without extracellular mucin production.     

乳腺神经内分泌癌的临床病理学特点

目的 探讨具有神经内分泌特征乳腺癌的临床病理特点，加深对其认识。方法 观察5例乳腺神经内分泌癌的组织学特征并进行免疫组化染色，判定标准为≥50％肿瘤细胞表达Syn、CgA或NSE。结果 4例女性，1例男性。年龄54～90岁(平均70岁)。肿瘤直径2．5～5．5cm(平均3．5cm)。有淋巴结转移者2例。组织学形态包括富于细胞的黏液型、实性岛状型、弥漫实性粘附型、非典型类癌型和小细胞癌型。5例均表达Syn、CgA、NSE、AE1/AE3和EMA；2例表达Lue-7，2例表达CK7；3例表达E-cad；S-100蛋白均阴性，2例ER和PR阳性，3例p53阳性，1例表达c-erbB-2，4例表达bcl-2，Ki-67阳性率17％～85％。随访时间4～69个月(平均32．2个月)，除小细胞癌患者死亡外，均存活。结论 乳腺神经内分泌癌易发生在老年人，除小细胞癌外其他类型预后较好，它们在形态、功能和表型上常呈多向性，应该将它们从普通型的乳腺癌中区分出来。     

原代人宫颈癌细胞的培养方法

背景：在体外分离、培养宫颈癌上皮细胞, 从细胞水平及分子水平研究肿瘤病因及治疗的基础,是宫颈癌组织工程研究的最基本环节。 目的：探讨适用于组织工程宫颈癌研究的人宫颈癌原代细胞培养方法以及传代后细胞形态变化、增殖的特性。 方法：0.25%胰蛋白酶和2%Ⅰ型胶原酶联合消化法体外培养宫颈癌原代细胞,荧光倒置显微镜下观察肿瘤细胞形态、体外生长情况,免疫组化法检测体外培养宫颈癌细胞表面标记物CK17和肿瘤细胞增殖抗原Ki67表达。 结果与结论：采用胰蛋白酶与Ⅰ型胶原酶联合消化法体外分离培养人宫颈癌细胞,该法相对简单且重复性较好,所得到的原代细胞纯度较高。经体外传代培养的宫颈癌细胞仍可保持稳定的细胞表型。宫颈癌细胞表面标记物CK17阳性表达,证实细胞为上皮源性,肿瘤细胞增殖抗原Ki67表达阳性提示所培养细胞具有肿瘤细胞恶性增殖的特性。     

乳腺原发性腺泡细胞癌临床病理诊断

目的探讨乳腺原发性腺泡细胞癌的临床病理特征及诊断和鉴别诊断。方法对1例乳腺原发性腺泡细胞癌进行光镜观察及免疫组化标记。结果癌细胞由同种细胞组成,排列成实性巢状,细胞核圆形,胞质内富含颗粒,胞质嗜酸性或空泡状,透明细胞常见;免疫组化特征性表达CK、lysozyme、α-anti-chymotrypsin等抗体,有助于与其他肿瘤鉴别。结论乳腺腺泡细胞癌非常罕见,需要与乳腺浸润性导管癌、腺肌上皮瘤、颗粒细胞癌等鉴别。     

Fine-needle aspiration of metastatic renal-cell carcinoma masquerading as primary breast carcinoma

This report details a fine-needle aspiration biopsy performed in the investigation of two right breast nodules in a patient with previous history of lumpectomy for infiltrating ductal carcinoma in the same breast 3 years before. Because the cytology was atypical for a mammary carcinoma and cells did not match the morphology of the previous breast carcinoma, a tissue biopsy was recommended, revealing the presence of metastasis from a previously silent primary renal-cell carcinoma. This report illustrates not only how metastatic lesions in the breast can masquerade clinically as a primary carcinoma but also the necessity for the cautious approach to interpreting the fine-needle aspiration biopsy of these lesions. Furthermore, essential guidelines necessary to distinguish primary from metastatic lesions in the breast are presented. Diagn. Cytopathol. 1998;18:343–345. © 1998 Wiley-Liss, Inc.     

Nonepithelial malignancies mimicking primary carcinoma of the breast

Although primary carcinomas account for the majority of breast malignancies, nonepithelial malignancies form a subset that must be differentiated accurately for treatment purposes. The purpose of this study was to identify cytological characteristics that differentiate between these two entities. Twenty-six fine-needle aspiration (FNA) specimens with histological correlation were reviewed (five lymphomas, two myelomas, six sarcomas, seven melanomas, and six carcinomas). On review, nonepithelial tumors presented as single cells with scant or ill-defined cytoplasm with rare cluster formations present. In contrast, carcinomas were arranged predominantly in clusters and contained more-defined, abundant, and sometimes vacuolated cytoplasm. Moreover, a major aid to diagnosis was an accurate clinical history. We conclude that nonepithelial malignancies of the breast are best differentiated from epithelial malignancies by a combination of cytological features and clinical information. These findings emphasize the importance of the triple test, in which integration of cytological findings and clinical information play a key role.     

Histopathological characteristics and oestrogen receptor content in primary breast carcinoma

Summary 159 primary breast carcinomas were examined histologically with regard to grade of anaplasia, cellularity, amount of elastic tissue, and whether they were of ductal or lobular origin. Possible correlations between these variables and the oestrogen receptor (OR)-content were investigated. There was a marked tendency toward a greater number of OR-positive tumors in the group rich in elastosis. A significant correlation between the OR-content and the histological grade was found, whereas there was no correlation between either the OR-content or the grade of anaplasia and the cellularity. Furthermore, the group of tumors that were lobular in derivation had a significantly greater number of OER-positive tumors than the group ductally derived.Sponsored by the Danish Cancer Society     

Preferential involvement of chromosome 1q in a primary breast carcinoma

The cytogenetic findings by G- and C-banding in a primary breast carcinoma are reported. The tumor is characterized by a high modal number of chromosomes (79) and 14 markers of ten different origins. Chromosome #1 is more frequently involved in structural and numerical aberrations than is any other chromosome; nine copies of 1q were present in each cell examined. This observation supports the hypothesis that duplication of chromosome 1q may play an important role in the progression of malignant tumors.     

Electron microscopic studies of primary apocrine carcinoma of the breast

Three cases of apocrine carcinoma of the breast were investigated by light and electron microscopy. Histologically, the tumor cells were shown to have eosinophilic granular cytoplasm and occasional cytoplasmic snouts protruding into the lumen. Ultrastructurally, light and dark tumor cells were identified, and there were many lysosome-like dense bodies of various sizes and small dense granules grouped in the subapical region. Many mitochondria with incomplete cristae and numerous small vacuoles were distributed in the cytoplasm. Occasionally, intracytoplasmic lumen were visible in the tumor cells. These ultrastructural findings are quite similar to those found in normal apocrine sweat glands. However, the presence of an intraductal component of carcinoma suggests the origin to be mammary epithelial cells. This study was presented at the 25th Annual Meeting of the Clinical Electron Microscopy Society of Japan, Matsumoto, September 28–30, 1993.     

The evaluation of estrogen receptor in primary breast carcinoma by computer-assisted image analysis

A monoclonal antibody prepared against estrogen receptor has been shown to be specific and sensitive for the detection of estrogen receptor in human breast lesions by use of immunohistochemical methods. Two hundred selected cases of primary breast carcinoma were assayed for estrogen receptor content by biochemical and immunohistochemical procedures. Quantitative evaluation was by biochemical, immunohistochemical, and automated computer-assisted image analysis using the Cell Analysis System's CAS/100 machine (Lombard, IL). Quantitative estrogen receptor content was determined by dextran-coated charcoal analysis and sucrose density gradient analysis. Immunohistochemical evaluation incorporated both intensity and distribution of staining, yielding a subjective score, histologic score (HSCORE). An objective quantitation, also incorporating intensity and distribution of staining, was done by computer-assisted image analysis, quantitative immunocytochemical score (QIC SCORE). HSCORE analysis was done with and without methyl green counterstain with no loss of sensitivity. Comparison of QIC SCORE with the biochemical and immunohistochemical analysis of the tissues examined revealed excellent sensitivities and specificities. These data suggest that automated image analysis provides an effective qualitative and quantitative means of evaluating estrogen receptor content in human breast cancers.     

转移消失基因在乳腺癌中的表达及其临床意义

目的:探讨转移消失(missing in metastasis,MIM)基因在乳腺癌及癌旁组织中的表达及其与乳腺癌临床病理特征的关系.方法:采用SYBR Green实时定量PCR技术检测60例乳腺癌及癌旁组织MIM mRNA的表达,并分析其在不同临床参数间的表达差异.结果:MIM mRNA在乳腺癌中的表达高于癌旁组织(...