乳腺神经内分泌癌35例临床病理分析

目的介绍并讨论乳腺神经内分泌癌的临床病理学特征。方法对35例乳腺神经内分泌癌的临床表现、组织学形态、免疫表型及预后进行研究。结果35例均为女性患者,发病年龄28~95岁(平均60.4岁)。肿块大小0.8~5cm(平均2.04cm)。组织学形态包括:实性黏附型(15例)、腺泡型(10例)、实性乳头型(5例)、细胞黏液型(2例)、小细胞/雀麦细胞癌(2例)、大细胞癌(1例)。所有病例NSE和CK阳性表达,分别有34例(97.1%)和21例(60.0%)表达Synaptophysin和chromogranin A,腋下淋巴结转移率为25.0%(5/20例),除1例因发生肺和骨转移死亡外,其余患者均健在,随访时间2~76个月(平均32.1个月)。结论乳腺神经内分泌癌是一少见的独立病种,病理形态复杂,其生物学行为特性还需大样本较长期的随访观察。

Clinical and pathological analysis of 35 cases of breast neuroendocrine carcinoma

Objective To introduce and discuss the clinicopathological features in neuroendocrine carcinoma of the breast.Methods The clinical expressions,pathologic patterns,immunophenotypic features and prognosis were analysed.Results The 35 cases were female,ranged in age from 28 to 95 years old(mean 60.4).The tumor sizes were 0.8-5 cm(mean 2.04 cm)in diameter.The morphological types of these tumors were solid cohesive(15 cases),alveolar(10 cases),solid papillary(5 cases),cellular mucinous(2 cases),small cell(2 cases)and large cell carcinoma(1 cases).In all cases the tumor cells were stained positively with NSE and CK.Synaptophysin and chromogranin A positivity was detected in 34(97.1%)and 21(60.0%)cases,respectively.The rate of metastasis in axillary lymph nodes was 25.0%(5/20 cases).All cases but one(died of lung and bone metastasis)were alive with following up 2-76 months(mean 32.1 months).Conclusions These findings suggest that neuroendocrine carcinoma of the breast is a rare and distinct category with different histological subtypes.Its biological behavior need to be investigated by longer following up.