乳头Paget病临床病理特征分析

目的 :探讨乳头Paget病临床特点、组织发生伴发病理亚型、性激素受体表达状况等临床病理特征。方法 :回顾分析了 2 1例乳头Paget病患者临床病理资料 ,光镜下重阅分析其病理学特征 ,并采用免疫组化SP法检测ER、PR水平。结果 :2 1例乳头Paget病中 17例临床触及肿块 ,4例未触及肿块 ,全部伴乳腺导管癌 ,前者伴发浸润性导管癌 14例、早期浸润性导管癌 3例 ,后者全部为导管内癌。腋窝淋巴结转移率47 6% ( 10 /2 1)。组织学亚型与淋巴结状态关系密切 ,P <0 0 5。ER阳性率2 3 8% ( 5 /2 1) ,PR阳性率 2 8 6%( 6/2 1) ,ER、PR同时阳性 2 3 8% ( 5 /2 1)。性激素受体水平与淋巴结状态关系密切 ,P <0 0 5 ,而与伴发组织学类型无关 ,P >0 0 5。结论 :本组乳头Paget病均伴发乳腺导管癌 ,伴乳腺肿块者均为浸润性导管癌 ,淋巴结转移率高 ,ER、PR低水平表达。

Clinical pathological characteristics of paget disease of nipple and clinical significance of its hormone receptor status

OBJECTIVE:To explore the clinical feature, histological origin, pathological subtypes and hormone receptor status of Paget disease of the nipple.METHODS: Pathological features of 21 Paget diseases of the nipple were observed by microscope, and the ER and PR status were examined by immunohistochemical technology (SP method).RESULTS: All of the 21 patients with Paget disease of the nipple had the ductal carcinomas, including 17patients with a palpable mass(14 of 17 patients with invasive ductal carcinoma and 3 of 17 patients with ductual in situ carcinoma with microinvasion)and 4 patients with no palpabl mass (all with ductual in situ carcinoma). Axillary nodes were positive in 47.6% of all cases, which were invasive ductual carcinoma. The pathological subtype of Paget disease was associated with axillary node status significantly,P<0.05. The positive rates of ER and PR were 23.8% and 28.6%, respectively. Both ER and PR positive rates were found in 23.8%patients in this study. The hormone receptor status was associated with axillay node status significantly,P<0.05, but was not associated with pathological subtype,P>05.CONCLUSIONS: Patients with Paget disease of the nipple accompanied with palpable lesion in this study had a high positive rate of axillay node and a lower levels of ER and PR, which suggested that Paget diseases of the nipple with palpable lesion had a high malignant degree.