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乳腺大汗腺癌临床和病理学特征研究

Clinic and Pathological Study of Apocrine Carcinoma of Breast
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摘要 目的:探讨乳腺大汗腺癌(AC)的临床和病理学特征。方法:筛选出的8例乳腺大汗腺癌进行临床病理分析,采用过碘酸雪夫(PAS)、阿辛蓝(AB)染色及免疫组织化学A-P法检测GCDFP-15、Mucin-1、Ki-67、雄激素受体(Androgen receptor,AR)、雌激素受体(estrogen receptor,ER)、C-erbB-2。结果:8例均发生于中老年女性,因发现乳房包块就诊。组织学8例均为高级核,其中大汗腺导管原位癌(ADCIS)1例,ADCIS伴浸润性大汗腺癌(IAC)5例,IAC伴非大汗腺型DCIS灶2例。镜下主要有2种形态:A型,胞质嗜伊红染的粗颗粒状;B型,胞质淡染,呈细粉尘颗粒状,如毛玻璃样。8例AC的PAS染色阳性,AB染色在ADCIS阴性,在IAC可有50%细胞阳性,并同时表达GCDPF-15,AR,Mucin-1及Ki-67;除1例外,ER均不表达。结论:乳腺大汗腺癌的临床表现和大体形态与非乳腺大汗腺癌相似,多发生于单侧并且多数伴有同侧腋窝淋巴结转移,预后较好。其诊断主要依靠病理:(1)特征性的AC型细胞;(2)GCDPF-15阳性率高;(3)AR阳性率高,ER阳性率低。 To investigate the clinicopathological features and the immunohistochemica phenotype of apocrine carcinoma(AC)of breast. Method:The clinical and pathologic features of 8 cases with AC in breast were investigated. Periodic-acid-Schiff(PAS),alcian-blue staining were performed. The immunohistochemical study was performed by a panel of antibodies including gross cystic disease fluid protein 15(GCDFP-15),Mucin-1,AR,ER, c-erb-2 and Ki-67. Result:All 8 cases occurred in middle to old age female patients,complaining of mass in breast. Histologically,8 cases of apocrine carcinomas with high nuclear grade were confirmed,including 1 ADCIS,5ADCIS with IAC and 2 IAC. Two types of AC cells were noted according to the morphologic of cytoplasm:A type,neoplastic cells with copious,granular eosinophilic cytoplasm;B type,carcinoma cells with finely granular pale cytoplasm,like frosting glass. AC cells of 8 cases showed positivity for PAS,AB was negative in ADCIS and 50%positivity in IAC. 8 cases expressed GCDFP-15,AR,Mucin-1,Ki-67,all but 1 case was negative for ER. Conclusions:The clinic features of AC is similar to non-AC,frequency in unilateral and lymph node metastases in ipsilateral armpit,same prognosis with other types of breast carcinoma. Diagnosis of AC mainly depend on pathology:(1)Morphologicly,cells possessed of apocrine carcinoma features. (2)The positivity rate of GCDFP-15 is high.(3)The positivity rate of AR is high but low incident rate of positive ER.
出处 《中国医学创新》 CAS 2014年第22期1-4,共4页 Medical Innovation of China
基金 深圳市科技创新项目(20130401164750005) 国家自然科学基金青年科学基金项目(81301273)
关键词 乳腺肿瘤 大汗腺癌 免疫组织化学 雄激素受体 Mammary carcinoma Apocrine carcinoma Immunohistochemistry Androgen receptor
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参考文献18

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