乳腺浸润性微乳头状癌的临床病理特征及预后分析

目的:探讨乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)的临床病理特征及预后。方法:回顾性分析2011年1月至2015年12月246例于天津医科大学肿瘤医院收治的乳腺IMPC患者的临床病理资料,分为143例IMPC成分比例>50%(A组)和103例比例≤50%(B组)两组。多因素分析采用Cox比例风险回归模型,采用Log-rank检验及Kaplan Meier法等进行生存分析。结果:A组患者的5年无病生存(disease free survival,DFS)和总生存(overall survival,OS)时间均低于B组DFS(76.5%vs. 83.6%,P=0.042)和OS(74.1%vs. 81.6%,P=0.029)。A组中未行放疗患者的DFS和OS均低于行放疗患者的DFS(χ²=5.219,P=0.022)和OS(χ²=3.963,P=0.047)。Cox比例风险回归模型多因素分析显示,患者人类表皮生长因子受体-2(human epidermal growth facto...     

乳腺浸润性微乳头状癌临床病理分析

目的:探讨乳腺浸润性微乳头状癌(IMPC)的临床病理特征、诊断、鉴别诊断及预后。方法:回顾性分析7例乳腺IMPC患者的临床表现、组织病理特点、免疫组化结果,同时进行文献复习。结果:7例乳腺IMPC患者无特殊临床症状和体征。组织病理特点:IMPC肿瘤细胞团排列形成不含纤维血管轴心的微小乳头状或假腺管状结构,其外侧缘呈锯齿或毛刺状;每个肿瘤细胞团与周边的间质之间存在大小不等的腔隙,其内缺乏内容物。免疫组化染色EMA阳性部位在癌细胞巢团的外缘。结论:乳腺IMPC是一种特殊类型的乳腺浸润性癌,比较少见,但因其具有高淋巴血管侵犯、高淋巴结转移等恶性生物学行为,预后较差,应引起病理及临床医生的足够重视。     

Relationship between Lymphatic Vessel Density and Lymph Node Metastasis of Invasive Micropapillary Carcinoma of the Breast

OBJECTIVE To investigate the relationship between lymphatic vessel density and lymph node metastasis of invasive micropapillary carcinoma (IMPC) of the breast. METHODS The immunohistochemical study for vascular endothelial growth factor-c (VEGF-C), VEGF Receptor-3 (VEGFR-3) and lymphatic vessel density of 51 cases of IMPC were performed, and lymph node metastases were examined by microscopic analysis of these cases. RESULTS In IMPC, VEGF-C was expressed in the cytoplasm and/or on the membrane of the tumor cells, and the expression of VEGF-C showed a positive correlation with lymph node metastasis (P<0.01). Lymphatic vessel density was determined by the number of micro-lymphatic vessels with VEGFR-3 positive staining. Lymphatic vessel density was positively correlated with VEGF-C expression (P<0.01) and lymph node metastasis (P<0.01). The percentage of IMPC in the tumor was not associated with the incidence of lymph node metastasis. The metastatic foci in lymph nodes were either pure or predominant micropapillary carcinoma. CONCLUSION The results suggested that VEGF-C overexpression stimulated tumor lymphangiogenesis, and the increased lymphatic vessel density may be the key factor that influenced lymph node metastasis of IMPC.     

乳腺浸润性微乳头状癌Twist表达临床意义研究

目的：探讨乳腺浸润性微乳头状癌（invasivemicropapillarycarcinoma,IMPC）组织中Twist蛋白表达及其与临床病理学特征的关系和意义。方法：选取天津医科大学肿瘤医院乳腺病理研究室2008-01-01-2009-12-31收检的术前未经放化疗的103例IMPC患者石蜡包埋组织标本,并以同期108例乳腺非特殊型浸润性导管癌（invasiveductalcarci-nomanototherwisespecified,IDc-NOS）石蜡标本作为对照,采用免疫组织化学SP法检测肿瘤组织中Twist蛋白的表达水平,分析其与各临床病理学特征的关系。结果：IMPC组织Twist阳性表达率为56．3％（58／103）,明显高于IDC_NOS组织的41．7％（45／108）,差异有统计学意义,χ2=4．525,P=0．033。Twist的核表达与雌激素受体（endoplasmicreticulum,ER）（r=-0．301,P=0．002）呈负相关,与淋巴结转移（r=0．324,P=0．001）和软组织侵犯（r=0．428,P〈0．001）及淋巴管癌栓（r=0．507,P〈O．001）呈正相关;T胞质表达仅与ER（r=-0．262,P=0．007）呈负相关;而胞核或胞质的表达均与患者年龄、肿瘤大小、病理学分期、孕激素受体（progesteronereceptor,PR）和HER-2的表达无明显相关性,P〉0．05。Kaplan-Meier生存分析显示,Twist阳性表达的IMPC患者无病生存（DFS）低于Twist阴性表达患者,P=0．002;多因素分析显示,Twist表达及淋巴结转移是IMPC患者DFS的独立预后因子,相对危险度分别为2．771、2．202,P值分别为0．046,0．014。结论：Twist在乳腺IMPC组织中过表达,提示其可能在IMPC高侵袭、高转移中发挥重要作用,有可能成为靶向治疗研究的新靶点。     

乳腺浸润性微乳头状癌临床病理特征及其预后分析

目的：探讨乳腺浸润性微乳头状癌（invasive micropapillary carcinoma ,IMPC）的临床病理特征及预后分析。方法：回顾性分析河北医科大学第四医院2009年1 月至2011年12月确诊的65例乳腺IMPC 患者,采用免疫组织化学法检测上皮膜抗原（epithelial membrane antigen ,EMA）表达以确定微乳头成分在肿瘤中所占比例。按微乳头比例≤ 10% 、11% ～30% 、31% ～50% 、> 50%将患者分为4 组,并同时检测ER、PR、HER-2 的表达。Kaplan-Meier 单因素生存分析中行Logrank 检验,采用多因素Cox 风险回归模型行生存时间的影响因素分析。结果：65例乳腺IMPC 患者中单纯IMPC 12例,IMPC 伴浸润性导管癌46例,IMPC 伴其他浸润性癌7 例。乳腺IMPC 中微乳头比例≤ 10% 组为7.69%（5/ 65）、11% ～30% 组为44.62%（29/ 65）、31% ～50% 组为26.15%（17/ 65）、>50% 组为21.54%（14/ 65）,4 组乳腺IMPC 患者中淋巴结转移阳性率差异具有统计学意义（P < 0.01）。 免疫组织化学法结果显示,ER、PR和HER-2 在乳腺IMPC 组织中的阳性率分别为76.92%（50/ 65）、67.69%（44/ 65）和24.62%（16/ 65）,差异具有统计学意义（P < 0.05）。 Kaplan-Meier 单因素分析显示患者生存时间与淋巴结转移数,微乳头比例,脉管瘤栓,ER、PR、HER-2 的表达相关（P <0.05）。结论：淋巴结转移数,微乳头比例,脉管瘤栓,ER、PR及HER-2 的表达均与乳腺IMPC 的预后相关。     

Hsp27在乳腺浸润性微乳头状癌中的表达及其意义

  目的   乳腺浸润性微乳头状癌(IMPC)具有特殊的组织学形态特征及淋巴结转移率高的生物学特性。本研究旨在通过比较蛋白质组学技术筛选, 并验证乳腺IMPC与最常见的非特殊型浸润性导管癌(IDC-NOS)间差异表达的蛋白, 从蛋白质角度研究探讨乳腺IMPC的特殊组织学形态及生物学行为机制。   方法   双向电泳筛选1例乳腺IMPC和1例乳腺IDC-NOS冻存组织的蛋白表达差异点, 质谱鉴定其所对应的蛋白质, 免疫组织化学染色检测验证其在43例IMPC和30例IDC-NOS组织切片中的表达。   结果   筛选出表达稳定差异的蛋白—热休克蛋白27(Hsp27), 且Hsp27在IMPC中表达上调。免疫组织化学染色验证了Hsp27主要表达于肿瘤细胞质中, 其在IMPC中的表达明显高于IDC-NOS(Z=-3.236, P=0.001), 并与ER(r=0.319, P=0.037)及淋巴结转移数(r=0.444, P=0.003)呈正相关, 而与患者年龄、病理学分期、PR和HER-2表达无明显相关性。   结论   Hsp27在乳腺IMPC中过表达, 且与淋巴结转移数呈正相关, 提示Hsp27可能在IMPC淋巴结转移以及特殊的病理形态形成中起着重要作用。      

乳腺浸润性微乳头状癌临床病理特征及预后分析

目的 乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)是一种特殊类型的乳腺浸润性癌,易发生淋巴管、血管侵犯,但对其预后的认识仍存在分歧.本研究拟探讨IMPC的临床病理特征及预后相关性,为临床治疗提供指导.方法 采用回顾性分析的方法,形态学观察并评估2006-06-19-2015-10-28国家癌症中心中国医学科学院肿瘤医院病理确诊的89例乳腺IMPC中微乳头状结构的比例,应用免疫组化方法检测ER、PR、HER2及Ki-67的表达,并对各临床病理因素进行生存分析.结果 肿瘤内微乳头状癌比例>50%组ER阳性率为85.7%,高于微乳头状癌比例25%~50%组(57.1%)和<25%组(40%),P=0.013;单纯性IMPC组伴脉管瘤栓比率为58.8%,高于混合性IMPC组的32.4%,P=0.018.随访资料显示,微乳头状癌比例>50%组复发/转移率为9.1%,低于微乳头状癌比例25%~50%组(28.6%)和<25%组(40.0%),P=0.047.Kaplan-Meier单因素生存分析显示,微乳头状癌成分>50%组无瘤生存期长于微乳头状癌成分25%~50%组与<25%组,χ2=4.296,P=0.038;ER阳性组无瘤生存期长于ER阴性组,χ2=5.324,P=0.021;原发肿瘤T1组无瘤生存期长于T2组,χ2=7.302,P=0.026.Cox多因素生存分析未发现,影响乳腺IMPC无瘤生存时间的独立预后因素.结论 乳腺IMPC虽然易于发生脉管侵犯,但其侵袭性、转移能力及恶性度并不因而增高;原发肿瘤大小、ER状态、微乳头癌比例可能与其预后相关,但有待扩大样本及更长期随访数据的支持.     

A case of invasive micropapillary carcinoma of the breast

BACKGROUND: Invasive micropapillary carcinoma (IMP) of the breast is uncommon and has only recently been characterized. Knowing the cytological appearance of IMP is important to enable early diagnosis by fine needle aspiration cytology (FNAC). We describe a case of IMP diagnosed by preoperative FNAC.CASE: A 48-year-old menopausal woman presented in 2003 with a mass in her left breast. Mammogram and ultrasound findings indicated that the tumor was malignant. Cytological examination showed papillary clusters of hyperchromatic cells with irregular and crowded nuclei, but lacking papillary cores. No myoepithelial cells were seen. Based on the cytological findings, invasive micropapillary carcinoma was diagnosed. Microscopic findings showed cancer cells with moderate atypia in abundant micropapillary cancer nests without a fibrovascular core. These cancer nests were morula-like, surrounded by empty, clear spaces lined with delicate strands of fibrocollagenous stroma. The polarity of each cancer nest was reversed, with the secretion border facing fibrocollagenous stroma. These pathological features occupied the invasive part of the primary tumor. CONCLUSION: The cytologic features of IMP are distinctive and correlate with histology. FNAC of IMP is important role to confirm the diagnosis.     

乳腺浸润性微乳头状癌转移机制的研究进展

乳腺浸润性微乳头状癌(Invasive micropapillary carcinoma, IMPC)是一种罕见的乳腺癌组织病理学变异,约占所有乳腺癌的3%～8%。尽管IMPC的发病率较低,但与非特殊类型浸润性导管癌(Invasive ductal carcinoma of no special type, IDC-NST)相比,IMPC显示出更高的淋巴管浸润和淋巴结转移倾向。因此,了解其转移机制对于干预临床诊疗过程显得尤为重要。本文旨在综述IMPC的转移机制及相关临床证据,从而为IMPC的治疗提供新的思路。     

Population-based comparison of prognostic factors in invasive micropapillary and invasive ductal carcinoma of the breast

Background:

Invasive micropapillary carcinoma (IMPC) is a variant of breast carcinoma with a higher propensity for lymph node metastases compared with invasive ductal carcinoma (IDC).

Methods:

Retrospective analysis of 636 IMPC and 297 735 IDC cases in the Surveillance, Epidemiology and End Results database comparing disease-specific survival (DSS) and overall survival (OS) between IMPC and IDC.

Results:

A higher percentage of IMPC cases (52.0%) had nodal metastases compared with IDC cases (34.6%). The 5-year DSS and OS for IMPC was 91.8% and 82.9%, respectively compared with 88.6% and 80.5% for IDC, respectively. For both IMPC and IDC, oestrogen-receptor positivity was associated with better survival, while having four or more positive lymph nodes or larger tumour size correlated with worse survival. Radiotherapy provided a survival benefit for both histological types.

Conclusions:

Despite IMPC''s higher propensity for lymph node metastasis, IMPC has DSS and OS that compare favourably with IDC.     

乳腺浸润性微乳头状癌的研究现状

乳腺浸润性微乳头状癌（invasive micropapillary carcinom,IMPC）是乳腺癌一种特殊类型,具有独特的微乳头状结构及生长方式,发病率较低,约占所有乳腺癌的3%～6%。相比较于其他类型浸润性乳腺癌,IMPC具有更高的淋巴结转移率和更强的淋巴管侵袭性的特征,其恶性程度高、预后差,近年来引起国内外病理以及临床医师的高度关注。     

乳腺浸润性微乳头状癌的临床病理特征及诊疗现状

乳腺浸润性微乳头状癌（invasive micropapillary carcinoma of the breast,IMPC）是一种具有高度侵袭性的组织学类型。它与广泛的淋巴结转移及脉管侵犯显著相关,提示其预后较差。病理学诊断是识别乳腺浸润性微乳头状癌的主要方法,其镜下典型的特征为“主、间质分离”,即排列成桑葚状的肿瘤细胞簇似漂浮在由透明的胶原纤维基质构成的空旷而清晰的空间中。因其发病率不高,目前在治疗方面尚无标准的治疗策略,但鉴于它高度的淋巴结和脉管侵犯倾向以及较高的局部复发率,近年来吸引了越来越多的研究者探索其分子遗传学机制和诊疗方案。     

Clinical and pathologic features of invasive micropapillary carcinoma

Background  Invasive micropapillary carcinoma (IMC) of the breast is a rare subtype of breast carcinoma that has an extremely high incidence of lymph node metastases and poor clinical outcome. This histological subtype of breast carcinoma has remained unclear due to the rarity of cases. Many questions exist on the clinicopathological significance of this subtype, especially regarding prognosis. Methods  We reviewed all 671 cases of primary breast carcinoma that were surgically resected at our institute between 1990 and 2003. Of these, 27 cases of invasive ductal carcinoma of the breast with a pure or partial micropapillary component were reported. The cases were analyzed using various parameters, including age at presentation, tumor size, tumor grade, presence of lymphatic invasion, and axially lymph node status. Results  The patients’ age at presentation ranged from 31 to 74 years (mean 52.4 years). Tumor size ranged from 0.7 to 10 cm (mean 4 cm). 88.9% (24 of 27) of the cases had lymphatic invasion. Of cases who underwent with axillary dissection, 66.6% (18 of 27) had positive lymph nodes. Clinical follow up data were available for 17 cases with IMC for 1 to 72 months. Among these, 10 patients died from breast carcinoma within 5 years. Conclusion  While our series is too small to make conclusions about the behavior of IMC, the difference in 6-year survival rate between the patients with IMC and those with breast carcinoma in general was statistically significant. Recognition of this distinctive and aggressive variant of infiltrating carcinoma is important because of its poor prognosis and high incidence of lymph node metastases.     

乳腺浸润性微乳头状癌7例临床病理观察及文献复习

目的:探讨乳腺浸润性微乳头状癌(IMPC)的临床病理特点、诊断、鉴别诊断及预后。方法:通过7例IMPC的临床表现,组织形态学特征和免疫组化表达并文献复习。结果:7例乳腺IMPC发病年龄28-67岁,平均46.5岁,无特殊临床症状和体征。组织学表现为具有特征性的IMPC组织结构即肿瘤细胞乳头状或桑葚样排列,由纤细的胶原纤维或纤维血管间质分隔,两者间有一透明扩张的腔隙,呈弥漫性或结节状浸润生长。7例中5例有血管淋巴管内癌栓,伴有较高的淋巴结转移率(67/100)。免疫组化EMA线状表达于肿瘤乳头外侧缘和腺管样结构的内侧缘;E-cadherin强表达于瘤细胞间连接面的细胞膜,而微乳头间质面的细胞膜表达减弱。CD31显示微乳头缺乏纤维血管轴心。Ki67表达率为10%-15%。ER、PR和HER2的表达则不尽相同。结论:IMPC为一种具有特殊形态学表现的高侵袭、高转移潜能的乳腺癌,具有较高的恶性生物学行为。特征性的组织形态学结构结合EMA、E-cadherin、CD31等标记物检测有助于IMPC的诊断和鉴别诊断。     

乳腺浸润性导管癌的超声特征及其与分子分型的相关性

目的:研究乳腺浸润性导管癌的超声表现特征,分析其与临床病理参数的关系。方法:回顾分析我院2014年1月至2018年12月乳腺外科收治的110例乳腺浸润性导管癌患者临床资料。按照不同分子亚型分为Luminal 型、HER-2 过表达型及TN 型。观察不同亚型乳腺浸润性导管癌患者的超声征象并对比分析。结果:彩色多普勒超声检测显示,乳腺浸润性导管癌病例肿块多呈现为形态不规则、边缘毛刺、垂直生长,以内部回声无变化、无微钙化发生、血流分级2级、淋巴结转移、弹性评分≥3分为主。乳腺浸润性导管癌不同分子分型中超声征象形态、边缘、方位、内部回声、微钙化、血流分级、弹性评分组间差异具有统计学意义（P＜0.05）,淋巴结转移与否差异无统计学意义（P＞0.05）。Luminal 型多见于形态不规则、边缘毛刺、垂直生长;TN型多见于形态规则、边缘光整、平行生长;HER-2过表达型多肿块内部微钙化、弹性评分≥3分。不同分子分型组间两两比较,Luminal型和TN型超声征象边缘、方位组间具有统计学差异（P＜0.012 8）;HER-2型和TN型超声征象边缘组间具有统计学差异（P＜0.012 8）;Luminal型和HER-2型超声征象内部回声、微钙化及弹性评分组间具有统计学差异（P＜0.012 8）。结论:乳腺癌超声特征与其分子分型存在一定关系,超声特征可为其分子分型提供一定参考信息。     

乳腺具有微乳头状结构黏液癌的免疫表型及预后研究*

目的：探讨乳腺具有微乳头状结构黏液癌（mucinous micropapillary carcinomas,MUMPC）的免疫表型及预后。方法：回顾性分析天津医科大学肿瘤医院乳腺病理研究室2003年1 月至2012年12月531 例确诊为乳腺单纯型黏液癌（pure mucinous carcinoma ,pMC ）的病例,筛选出其中的MUMPC及非微乳头状结构的pMC 病例（对照组pMC ）。 以134 例MUMPC为研究组,397 例对照组pMC 及281 例同期诊断为浸润性微乳头状癌（invasive micropapillary carcinoma ,IMPC）为对照组,3 组行临床病理学特征和生存与预后关系的分析比较,从以上病例中随机选取32例MUMPC、89例对照组pMC 、44例IMPC,行分泌型黏蛋白（MUC2、MUC5AC、MUC6）及神经内分泌指标Syn 的免疫组织化学染色,比较分析3 组的免疫表型特征。结果：MUMPC的HER-2 阳性率为12.5%（4/ 32）,低于IMPC 的27.3%（12/ 44）,但高于对照组pMC 的4.5%（4/ 89）,3 者之间有显著性差异（P = 0.001）;MUC2、MUC5AC和MUC6 表达在MUMPC与对照组pMC 中无显著性差异（P > 0.05）,仅MUC2 表达在MUMPC与IMPC 比较中有显著性差异（P <0.001）;神经内分泌相关指标Syn 表达在MUMPC与对照组pMC 比较中有显著性差异（P = 0.003）,而MUMPC与IMPC 相比无显著性差异（P > 0.05）。 Kaplan-Meier 生存分析显示,MUMPC的无病生存期（DFS）与总生存期（OS）低于对照组pMC （P < 0.001 与P =0.004）,但要高IMPC。结论：MUMPC的免疫表型、临床生物学行为及预后与单纯型黏液癌和IMPC 既有区别又有联系,临床诊疗中应对该类型给予足够的认识和正确归类,以避免治疗不足或过度。     

The reversed apical pattern of MUC1 expression is characteristics of invasive micropapillary carcinoma of the breast

Background  Invasive micropapillary carcinoma (IMPC) of the breast is a special subtype of invasive ductal carcinoma (IDC), which is known to have a high potential to metastasize to the axillary lymph node. However, it is sometimes difficult to differentiate IMPC from conventional IDC showing an IMPC-like pattern due to artifact (pseudo-IMPC). In the present study, we investigated the usefulness of immunohistochemical expression of MUC1 for distinguishing IMPC from pseudo-IMPC, and analyzed several clinicopathological parameters of IMPC and pseudo-IMPC cases. Methods  Eighty cases showing IMPC or IMPC-like pattern were selected from our surgical files of 1240 cases of IDC. We examined the expression of MUC1, D2-40 and CD34 by immunohistochemistry. Results  Eighty cases were classified into 9 cases (0.7%) of pure-IMPC, 31 cases (2.5%) of mixed-IMPC, and 40 cases of pseudo-IMPC, according to the expression pattern of MUC1. In pure-IMPC cases, MUC1 expression was found at the reversed apical membrane of neoplastic cell clusters, while in pseudo-IMPC, MUC1 expression was present in the whole cytoplasmic membrane and/or cytoplasm. There were no significant differences among the three groups in patient age, tumor size and nuclear grade of neoplastic cells. However, lymphatic invasion and lymph node metastasis in the pure-IMPC or mixed-IMPC cases were higher than those in pseudo-IMPC cases with statistically significant values. Pure-IMPC has a higher recurrence rate and lower overall survival compared to pseudo-IMPC [P=0.0165(DFS)P=0.025(OS) ]. Conclusions  This study demonstrated that immunohistochemistry of MUC1 is useful for the diagnosis of IMPC. The pure-IMPC cases had higher incidences of lymphatic invasion and lymph node metastasis, and also showed a poorer prognosis.     

具有微乳头状结构的乳腺黏液癌临床病理学观察及预后因素分析

背景与目的：乳腺黏液癌是一种好发于老年女性且预后较好的乳腺癌,形态学上表现为细胞外间质内有大量黏液,其中漂浮着癌细胞。在伴有黏液分泌的乳腺浸润癌中可见黏液湖中漂浮的肿瘤细胞呈微乳头状,将之命名为具有微乳头状结构的乳腺黏液癌（pure mucinous breast carcinoma with micropapillary pattern,MUMPC）。探讨MUMPC的临床病理学特征,并分析患者的预后影响因素。方法：回顾性分析2010年1月—2018年12月南京医科大学附属常州市第二人民医院收治的40例MUMPC患者的临床病理学资料。计数资料两组间比较采用χ ² 检验或精确概率检验,应用Kaplan-Meier法计算生存率,log-rank检验和COX回归模型进行单因素和多因素预后影响分析。结果：40例患者均为女性,年龄30~80岁,中位年龄56岁,40例患者均获得术后随访,随访时间为8.0~89.0个月,中位随访时间为60.0个月,1、3和5年无病生存（disease-free survival,DFS）率为100%、87%和62%,1、3和5年总生存（overall survival,OS）率为100%、95%和85%。单因素分析结果显示,肿瘤临床TNM分期、肿瘤最大径、淋巴结转移、脉管侵犯、肿瘤细胞核级别、神经内分泌标志、分子分型、Ki-67增殖指数是影响MUMPC患者预后的相关因素（P＜0.05）。多因素分析结果显示,肿瘤临床TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素（P＜0.05）。结论：MUMPC发病率较低,5年OS率较高。TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素。     

具有微乳头结构的乳腺黏液癌临床病理特征及预后研究

  目的   探讨具有微乳头结构的乳腺黏液癌（mucinous micropapillary carcinoma,MUMPC）的临床病理特征及其对预后的影响。   方法   回顾性分析天津医科大学肿瘤医院2003年9月至2008年12月192例收治且病理诊断为乳腺黏液癌（mucinous breast cancer,MBC）患者的临床病理资料。根据病理类型分为101例单纯型乳腺黏液癌（pure MBC,PMBC）及91例混合型乳腺黏液癌（mixed MBC,MMBC）。在101例PMBC中筛选出35例MUMPC作为研究组,66例无微乳头结构的PMBC作为对照组（定义为pMBC组）,分析各组临床病理特征及其对预后的影响。   结果   MUMPC组淋巴结阳性、Ki-67指数表达阳性患者比例较高,与对照组比较差异具有统计学意义（P < 0.05）。MUMPC组患者总体5年无病生存率（disease free survival,DFS）为96.1%,10年DFS为68.9%。pMBC、MMBC、MUMPC组的5年DFS分别为100.0%、91.9%、100.0%,10年DFS分别为91.8%、56.2%、73.0%,三组之间比较差异具有统计学意义（P=0.011）,对MUMPC预后因素行单因素分析发现,病理淋巴结分期为DFS的影响因素（P=0.006）。   结论   MUMPC的预后与pMBC相比较差,与MMBC相比较好。MUMPC患者中淋巴结分期是唯一影响预后的危险因素。对预后较差的患者,应予以更加积极的辅助治疗。      

Overexpression of Her2/neu,estrogen and progesterone receptors in invasive micropapillary carcinoma of the breast

BACKGROUND: Invasive micropapillary carcinoma (IMC) of the breast is a rare subtype of breast carcinoma that has an extremely high incidence of lymph node metastasis and poor clinical outcome. Furthermore, there has been interest in the prognostic markers related to the biological characteristics of breast carcinoma, such as the status of Her2/neu, estrogen receptor (ER) and progesterone receptor (PgR). MATERIALS AND METHODS: We reviewed 671 cases of primary breast carcinoma which were surgically resected between 1990 and 2003. Of these, 27 cases of invasive ductal carcinoma of the breast with a pure or partial micropapillary component were reported. Tests for Her2/neu protein, estrogen receptor (ER) and progesterone receptor (PgR) were performed on paraffin sections. The relationship among these markers was analyzed and statistical significance determined by chi-square test. CONCLUSION: The rate of Her2/neu protein overexpression, ER and PgR status was quite similar to those of common breast carcinomas.