54例隐匿性乳腺癌的临床病理特征分析  

Analysis of clinicopathological features of 54 patients with occult breast cancer

作　　者：姜明强[1] 张连平[1] 郭广成[1] 

机构地区：[1]郑州大学第一附属医院乳腺外科,河南郑州450052

出　　处：《河南医学研究》2013年第6期828-831,共4页Henan Medical Research

摘　　要：目的:分析隐匿性乳腺癌(occult breast cancer,OBC)的临床病理特征,为临床诊断和指导治疗提供更多依据。方法:回顾性分析经手术和病理证实的54例OBC患者的临床资料,并将同期45例非OBC患者作为免疫表型的对照组,研究该肿瘤的临床特点和病理生物学特性。结果:54例患者均以腋窝淋巴结肿大为主要症状。MRI临床检出率为81.3%(13/16),钼靶X线摄影临床检出率为51.9%(28/54),两者差异有统计学意义(P<0.05)。腋下淋巴结转移灶癌细胞特点多为中-低分化,表现为淋巴结弥漫浸润的、成片的、大Apocrine样细胞;免疫组化GCDFP-15、CK7、CK20和TTF-1的阳性率分别为83.3%、96.7%、6.7%和3.3%,与对照组相比差异无统计学意义(P>0.05);ER、PR的阳性率分别为46.7%和36.7%,显著低于对照组,差异有统计学意义(P<0.05)。结论:OBC以腋窝肿物为首发症状,MRI更有利于乳腺内可疑病灶的检出;OBC的ER、PR阳性率低,其确诊主要依靠术后病理和免疫组化指标。Objective： To provide more basis for diagnosis and treatment of occult breast cancer （OBC） by analyzing the clinicopathological features. Methods： The clinical data of 54 patients with OBC receiving surgical operation and confirmed by pathology were analyzed retrospectively. 45 patients with non-OBC were served as the control group for immunophenotyping. Results： Axil- lary mass was the first symptom of 54 patients with OBC. The detection rate of MRI was higher than molybdenum target X-ray （81.3 % ＆51.9% ）, the difference was statistically significant（P 〈 0.05 ）. Most of the ceils in axillary metastatic lymph nodes were moderate or poorly differentiated, diffusely infiltrated lymphonodus, were large pieces and big Apocrine-like cells. The positive rates of GCDFP-15,CK7, CK20 and TTF-1 were 83.8% , 96.7% , 6.7% and 3.3%. There were no differences from the control group （P 〉 0.05） ; the positive rates of ER and PR were 46.7% and 36.7% which were lower than the control group,the differences were statistically significant（P 〈 0. 05）. Conclusion ： Axillary mass is the first symptom of OBC, MRI is helpful to detect the sus- picious focuses of breast ; the positive rates of ER and PR in OBC were lower, The diagnosis of oc- cult breast cancer mainly depends on postoperative pathology and immunohistochemical pheno- types.

关 键 词：隐匿性乳腺癌 临床特点 病理特征 

分 类 号：R737.9[医药卫生—肿瘤]