乳腺癌新辅助化疗后残留癌组织的病理分析

目的探讨和分析乳腺癌新辅助化疗后残留癌组织变性区病理形态特点,为正确评价该治疗方法提供理论依据.方法应用病理形态学、免疫组化技术以及细胞凋亡检测技术(PCD)进行分析.结果10例导管浸润癌中有2例未找到残留癌组织,1例仅见少量残留癌组织,7例有不同程度癌组织残留.残留癌组织分为变性癌组织区(DCC)和非变性癌组织区(NDCC).比较两者癌细胞的PCNA表达,NDCC明显高于DCC,而PCD检测DCC阳性癌细胞高于NDCC.浸润淋巴细胞以T细胞为主.10例中有4例32个腋窝淋巴结发生癌转移,其中20个出现了DCC改变.结论新辅助化疗乳腺癌后残留癌组织DCC变化是反映其疗效的一种形态变化,它可以通过启动细胞凋亡途径使癌细胞坏死以及使细胞增殖能力降低,激发局部组织抗肿瘤的细胞免疫能力,杀死部分淋巴结转移的癌细胞.

Pathological Analysis of the Residual Cancer from Neoadjuvant Chemotherapy in Breast Cancer

Objective: To search and analyse the pathological features of the degenerated residual cancer from neoadjuvant chemotherapy in breast cancel. Methods: Ten patients with advanced breast cancer were investigated pathologiclly , immunohistochemically and with the apoptosis test (PCD). Results: Of ten patients with breast cancer, 2 cases had nonresidual tumour tissues, 1 with a little and 7 of different, amount for histopatholoical grading. The residual tumour tissues were divided into degenerated cancer cells (DCC) and non - degenerated cancer cells (NDCC). The NDCC had more high positive rate for PCNA antibody than the DCC, and the PCD presented more reactive cancer cells in the DCC than in the NDCC. The lymphocytes in the DCC were mainly T cells. Of 32 metastatic lymph nodes there were 20 lymph nodes. showed DCC changes. Con- clusion: The necrosis and degeneration of breast cancer cells were induced by neoadjuvant chemotherapy and thus with decreasing the proliferative rate and increasing the immurity.