乳腺癌新辅助化疗后残留癌组织的病理分析  

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

作　　者：谭云山[1] 陈君雪[1] 纪元[1] 周燕南[1] 张王海[1] 亓发芝[1] 

机构地区：[1]上海医科大学附属中山医院,200032

出　　处：《中国临床医学杂志》2000年第1期58-60,共3页

摘　　要：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（ＮＤ－ＣＣ）。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。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.

关 键 词：新辅助化疗 乳腺癌 病理学 残留癌 

分 类 号：R737.9[医药卫生—肿瘤]