乳腺柱状细胞病变临床病理分析  

Clinicopathological analysis of breast columnar cell lesions

作　　者：郭晓静[1,2] 刘汉勇[1,2] 王晓玫[1,2] 成志强[1,2] 胡锦涛[1,2] 金红涛[1,2] 

机构地区：[1]暨南大学第二临床学院 [2]深圳市人民医院病理科,广东深圳518020

出　　处：《新乡医学院学报》2015年第7期646-648,共3页Journal of Xinxiang Medical University

摘　　要：目的探讨乳腺柱状细胞病变(CCL)的临床病理特点。方法对78例乳腺CCL标本进行组织形态学观察和免疫组织化学检测。结果 CCL均为镜下病灶,无独立的大体形态特点。乳腺柱状细胞变(CCC)和柱状细胞增生(CCH)的形态学特征:腺泡伴有不同程度的扩张,被覆上皮常有顶浆分泌突起,形态不规则;细胞核为卵圆形,垂直于基底膜排列,染色质分布较均匀,核仁不明显;肌上皮有时被挤压,被覆上皮只有1层或2层时诊断为乳腺CCC,超过2层分层排列或突起时诊断为CCH。乳腺平坦型上皮不典型增生(FEA)的形态学特征:腺泡扩张,上皮呈单层或多层,缺乏极向;病变细胞核圆形,核仁不明显;细胞为立方形或柱状,常有顶浆分泌,腺泡结构尚规则,通常伴有微小钙化。免疫组织化学检测结果显示,78例CCL中细胞角蛋白(CK)5/6均呈阴性表达,雌激素受体、CK8/18及孕激素受体阳性表达率均为98.72%(77/78),人表皮生长因子受体2阳性表达率为2.56%(2/78),78例CCL中p63染色均可以显示肌上皮细胞。结论 CCL是乳腺低级别癌前病变,病理诊断主要依赖组织形态学观察,免疫组织化学检测有助于其诊断。Objective To investigate the clinicopathological characteristic of breast columnar cell lesion（ CCL）. Methods A total of 78 samples of breast CCL were performed with histological observation and immunohistochemistry. Results CCL was microscopic pathological changes without independent morphological characteristics. The morphological features of columnar cell change（ CCC） and columnar cell hyperplasia（ CCH） including that the acini had different expansion,covering epitheliums had irregular apocrine gland; the ovoid mesoplasts were perpendicular to the basement membrane,the chromatin distributed evenly,and no obvious nucleolus; the myoepithelium were sometimes extrusion; the lesions were diagnosed as CCC when the epitheliums were only 1 or 2 layers; the lesions were diagnosed as CCH when the covering epitheliums were more than2 layers or protrusion. The morphological features of flat epithelial atypia（ FEA） including that the acini had expansion,covering epitheliums were monolayer or multilayer without polar direction; the mesoplasts were sphericala,and no obvious nucleolus;the cells were cube or prismatical and often had apocrine gland,the acinar structures were still regular and often had microcalciffcation. The results of immunohistochemistry showed that cytokeratin（ CK） 5 /6 was negative expression in 78 cases of CCL;the positive expression rate of estrogen receptor,CK8 /18 and progesterone receptor was 98. 72%（ 77 /78）,the positive expression rate of human epithelial receptor-2 was 2. 56%（ 2 /78）; p63 staining could display the myoepithelial cells in 78 cases of CCL. Conclusions CCL is the elementary precancerous lesions of breast. The diagnosis of CCL depends on the pathological histological observation,the immunohistochemical tests will help to its diagnosis.

关 键 词：柱状细胞病变 平坦型上皮不典型增生 免疫组织化学 

分 类 号：R737.9[医药卫生—肿瘤]