乳腺复发性叶状肿瘤临床病理分析

目的:探讨乳腺复发性叶状肿瘤临床及病理特征。方法:收集2011年01月至2019年12月在我院进行手术治疗的叶状肿瘤病例，并找出其中复发的病例，分析复发病例的临床及病理组织学特征。结果:叶状肿瘤137例，共有10例为复发病例，其中9例为单次复发，1例复发两次，复发病例中良性叶状肿瘤7例，交界性叶状肿瘤2例，恶性叶状肿瘤1例。所有的肿物均为局部复发，良性、交界及恶性叶状肿瘤复发率分别为5.9%、15.4%、20%。其中3例（30%）出现组织学升级，1例良性叶状肿瘤复发为交界性叶状肿瘤，1例交界性叶状肿瘤复发为恶性叶状肿瘤，1例良性叶状肿瘤第一次复发为交界性叶状肿瘤，第二次复发为恶性叶状肿瘤。免疫组化标记CD117、CD34、CD10、p53、p16在原发及复发肿瘤中表达无差异。Ki67增殖指数在复发病例中均升高，并且核分裂数也增多。结论:良性、交界性、恶性叶状肿瘤均可复发，其中恶性叶状肿瘤复发率最高，肿瘤多为局部复发，部分肿瘤复发后出现组织学升级，复发后肿瘤细胞增殖活性增强。

Analysis clinical and pathological features of recurrent breast phyllodes tumors

Objective:To investigate the clinical and pathological features of recurrent phyllodes tumors.Methods:The cases of phyllodes tumors treated by surgery in our hospital from January 2011 to December 2019 were collected,and the recurrence cases were identified,then the clinical and histopathological features of the recurrence cases were analyzed.Results:137 cases of phyllodes tumors were collected,with a total of 10 cases of recurrence,including 9 cases recurred for once and 1 case for twice,in all of them,7 cases of benign phyllodes tumors,2 cases of borderline phyllodes tumors and 1 case of malignant phyllodes tumor.All tumors were local recurrence.The recurrence rates of benign,borderline and malignant tumors were 5.9%,15.4%and 20%,respectively.Histological progression occurred in 3 cases,1 case of benign phyllode tumor recurred to borderline phyllode tumor and 1 case of borderline phyllode tumor recurred to malignant phyllode tumor,1 case of benign phyllode tumor recurred to borderline phylloder tumor for the first time and malignant phyllode tumor for the second time.Immunohistochemical markers of CD117,CD34,CD10,p53,p16 showed no difference in expression between primary and recurrent tumors.The proliferation index of Ki67 recurred,and the number of mitotic increased.Conclusion:Benign,borderline or malignant phyllodes tumors may relapse,the recurrence rate of malignant phyllodes tumors is the highest,most of which are local recurrences,the proliferative activity of the tumor increased after recurrence.