31例乳腺乳头状癌的临床病理特征及治疗  

Clinicopathological characteristics and therapy of 31 cases of papillary carcinoma of the breast

作　　者：蔡仕彬[1] 潘颖[1] 毛卫波[2] 张敏[2] 陈述政[1] CAI Shibin;PAN Yin;MAO Weibo;ZHANG Min;CHEN Shuzheng(Department of Breast Surgery, Lishui Central Hospital, Lishui, 323000;Department of Pathology, Lishui Central Hospital, Lishui, 323000)

机构地区：[1]丽水市中心医院乳腺外科,浙江丽水323000 [2]丽水市中心医院病理科,浙江丽水323000

出　　处：《温州医科大学学报》2017年第10期771-774,共4页Journal of Wenzhou Medical University

基　　金：丽水市简易招标科技项目(2010JYZB23)

摘　　要：目的:探讨乳腺乳头状癌的临床及病理特征、治疗方式及预后。方法:分析2010年8月至2016年12月丽水市中心医院收治的31例乳腺乳头状癌病例的临床资料。所有病例均行HE染色及免疫组织化学染色病理检查,同时采用荧光原位杂交(FISH)行HER2基因检测。结果:乳腺乳头状癌的发病率占同时期乳腺癌的2.71%,多以发现乳房无痛性肿块或乳头血性溢液为首诊表现。9例患者行乳腺癌改良根治术,18例患者行单纯乳房切除+前哨淋巴结活检术;1例患者行保乳手术+前哨淋巴结活检术,术后7例接受辅助化疗,2例接受放疗,全部病例均接受内分泌治疗。25例患者腋窝淋巴结阴性。31例患者均表达雌激素受体或孕激素受体,人表皮生长因子受体表达阴性者29例。随访时间6~80个月,1例患者全身骨显像显示腰椎骨转移,其余患者均无病生存,生活质量良好。结论:乳腺乳头状癌的治疗及预后与其病理类型密切相关。导管内乳头状癌、包被性乳头状癌及实性乳头状癌预后较好,可按照原位癌治疗原则处理。Objective： To investigate the clinical and pathological characteristic, therapy method and prognosis in papillary carcinoma of the breast. Methods： The clinical data of 31 cases of patients with breast papillary carcinoma admitted to Lishui Central Hospital from August 2010 to December 2016 were retrospectively analyzed. All cases were performed hematoxylin-eosin（HE） staining and immunohistochemical staining pathologic examination. And the expression of human epidermal growth factor receptor 2（HER2） gene amplification was detected by fluorescence in situ hybridization. Results： The morbidity of breast papillary carcinoma accounted for 2.71% of breast cancer at the same period, and in most cases painless bony mass in breast or papilla hemorrhagic discharge was discovered in initial diagnosis. Nine patients were undergone modified radical mastectomy, 18 cases were undergone total mastectomy plus sentinel lymph node biopsy（SLNB）, and 1 case was undergone breast-conserving radical operation of mastocarcinoma and SLNB. After the operation, 7 cases received adjuvant chemotherapy, 2 cases received radiotherapy and all patients were undergone endocrine therapy. 25 cases had negative result in axillary lymph nodes. 31 cases expressed estrogen receptor or progesterone receptor and 29 cases had negative result in the expression of HER2. The follow-up time was 6 to 80 months, 1 case showed lumbar vertebra metastases in whole-body bone scanning. Other patients had disease free survival and had good living quality. Conclusion： The treatment and prognosis of breast papillary carcinoma are closely related to the pathological pattern. Intraductal papillary carcinoma, encapsulated papillary carcinoma and solid papillary carcinoma have good prognosis and can be dealt with in accordance with the therapeutic principle of carcinoma in situ.

关 键 词：乳腺乳头状癌 导管内乳头状癌 包被性乳头状癌 实性乳头状癌 病理学 临床 

分 类 号：R655.8[医药卫生—外科学]