腋窝副乳腺组织发生的浸润性微乳头状癌的临床病理和免疫组织化学研究  

Invasive Micropapillary Carcinoma of the Axillary Accessory Mammary Gland: A Clinicopathologic and Immunohistochemical Study

作　　者：郎荣刚[1] 郭晓静[1] 范宇[1] 陈凌[1] 付丽[1] 

机构地区：[1]乳腺癌防治教育部重点实验室,天津市肿瘤防治重点实验室,天津医科大学附属肿瘤医院乳腺病理研究室,天津市300060

出　　处：《中国肿瘤临床》2010年第9期517-519,526,共4页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金(编号:30600225,30930038);教育部长江学者乳腺癌创新团队支持计划(编号:IRT0743);科技部十一五“863”计划重大项目(编号:2006AA02A249);国家重点基础研究发展计划“973”项目资助(编号:2009CB521700)~~

摘　　要：目的:研究发生于腋窝副乳腺组织的原发性浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)的临床病理和免疫表型特征。方法:对发生于腋窝的肿物局部广泛切除标本采用组织全切片法取材制片,应用免疫组织化学方法(SP法)检测肿瘤组织中ER、PR、cerbB-2、p53、上皮膜抗原(EMA)、E-钙黏附素、α-连环素和β-连环素的表达。结果:病理组织学发现肿物由IMPC和导管内癌两种成分组成,分别占95%和5%,癌旁可见正常乳腺组织,且与同侧固有乳腺组织间无连续,证实腋窝部肿瘤为副乳腺组织发生的原发性IMPC。肿瘤组织内可见癌侵犯淋巴管,43枚腋下淋巴结中35枚可见转移灶,侵犯到淋巴管内及淋巴结转移灶内的癌组织均与原发灶形态相同。免疫组织化学染色显示肿瘤组织ER和PR阳性,p53和cerbB-2阴性,EMA在肿瘤细胞簇外表面,即面向间质侧呈阳性表达,E-钙黏附素、α-连环素和β-连环素在癌细胞团内的细胞间连接处呈强表达,而癌细胞团的外表面无表达。结论:发生于腋窝副乳腺组织的IMPC临床病理和免疫组织化学特征与原发于乳腺的IMPC特征相同,并具有同样的高侵袭和转移潜能。Objective： To study the clinicopathologic and immunohistochemical characteristics of primary invasive micropapillary carcinoma （IMPC） arising in the axillary accessory mammary gland. Methods： The patients underwent wide local excision then pathologists examined the whole specimen in a series of sections. Immunohistochemical staining of ER, PR, cerbB-2, P53, epithelial membrane antigen （EMA）, E-cadherin, α-Catenin and β-Catenin was performed. Results： The tumor was composed of IMPC and ductal carcinoma in situ, accounting for 95% and 5%, respectively. Normally positioned breast tissue was seen beside the axillary tumor. The neoplasm was diagnosed as primary IMPC arising in the axillary accessory mammary tissue. Lymphatic vessels with invasion were seen within the tumor and metastases were detected in 35 of the 43 axillary lymph nodes. Morphologic appearance of the carcinoma in the lymphatic vessels and positive lymph nodes was the same as in the primary carcinoma. Immunohistochemistry showed that tumor cell clusters were positive for ER and PR and negative for P53 and cerbB-2. A peculiar immunoreactivity for EMA limited to the cytoplasmic membrane oriented toward the stroma and an absence of immunoreactivity for E-cadherin, α-Catenin and β-Catenin in the same side of the cytoplasmic membrane indicated inversion of cell polarization and a disturbance in the cell adhesion molecules. Conclusion： The clinicopathologic and immunohistochemical characteristics of the IMPC arising in axillary accessory mammary glands are identical with the IMPC of the breast, with high potential of invasion and metastasis.

关 键 词：副乳腺 乳腺癌 浸润性微乳头状癌 免疫组织化学 

分 类 号：R737.9[医药卫生—肿瘤]