国际肿瘤学杂志

国际肿瘤学杂志 ›› 2014, Vol. 41 ›› Issue (2): 140-143.doi: 10.3760/cma.j.issn.1673-422X.2014.02.018

• 论著 • 上一篇    下一篇

乳腺髓样癌分子分型特点及临床病理观察

杨拥军, 张秀琳, 王作君, 刘景峰   

  1. 118300 辽宁省东港市中心医院病理科
  • 收稿日期:2013-08-30 修回日期:2013-12-20 出版日期:2014-02-08 发布日期:2014-01-26
  • 通讯作者: 杨拥军，E-mail: dg_yangyongjun@126.com E-mail:dg_yangyongjun@126.com

Molecular classification characteristics and clinicalpathological observation of breast medullary carcinoma

Yang Yongjun, Zhang Xiulin, Wang Zuojun, Liu Jingfeng   

  1. Department of Pathology, Donggang Central Hospital, Liaoning Province, Donggang 118300, China
  • Received:2013-08-30 Revised:2013-12-20 Online:2014-02-08 Published:2014-01-26
  • Contact: Yang Yongjun E-mail:dg_yangyongjun@126.com

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摘要： 目的 探讨乳腺髓样癌（MC）的分子亚型和免疫表型特征及其临床意义。方法 选取29例MC及180例中高级别非特殊型浸润癌（NST）标本。采用免疫组织化学方法，根据肿瘤细胞雌激素受体（ER）、孕激素受体（PR）、人类表皮生长因子受体2（HER2）、Ki67的表达进行近似分子分型。比较两组病例中基底样亚型的临床病理特征和上皮细胞钙黏蛋白(Ecadherin）、P53、Ki-67及CD57的表达情况。结果 MC与NST组中基底样型分别占58.6%（17/29）和12.2%（22/180）。两组基底样型癌P53、Ki-67、E-cadherin的表达差异无统计学意义(P＞0.05)，CD57阳性表达率分别为88.2%（15/17）和31.8%（7/22），差异有统计学意义(P=0.001)；两组淋巴结转移率均较低，而远处转移率分别为23.5%(4/17)和68.2%(15/22)，且差异有统计学意义(P=0.01)。结论 乳腺肿瘤中MC较少见，其组织学分级高，分子亚型以基底样型居多；与其他基底样型乳腺癌相比预后较好，可能与间质淋巴细胞浸润有关。

关键词: 乳腺肿瘤, 癌, 髓样, 免疫表型分型, 免疫组织化学

Abstract: Objective To explore the characteristics and clinical significance of molecular subtypes and immunophenotypes of breast medullary carcinoma (MC). Methods Molecular classification was performed in 29 specimens of MC and 180 middlehigh level invasive carcinomas of no specific type (NST) based on the expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2) and Ki-67 with immunohistochemical method. The expressions of Ecadherin, P53, Ki-67 and CD57 in basallike subtype carcinoma of two groups and the clinicalpathological features were analyzed retrospectively. Results The basal-like subtype carcinoma accounted for 58.6% (17/29) and 12.2% (22/180) in MC and NST group respectively. There were no statistical differences in the expressions of Ecadherin, P53 and Ki-67 between the two groups of basallike subtype carcinoma (P＞0.05). The CD57 positive expression rates of the two groups were 88.2% (15/17) and 31.8% (7/22), and the difference was statistically significant (P=0.001). The lymph node metastasis rates were lower, and the distant metastasis rate was 23.5% (4/17) in MC group and 68.2% (15/22) in NST group, which showed statistical difference (P=0.01). Conclusion In breast tumor, MC is less common, and its histological grade is high, and basal-like subtype is in the majority. This subtype in MC shows better prognosis than other basallike subtype carcinomas and lymphocytes infiltration in the stroma may be an important factor.

Key words: Breast neoplasms, Carcinoma, medullary, Immunophenotyping, Immunohistochemistry