乳腺实性乳头状癌临床病理特征及预后分析  

Clinical pathology characteristics and prognostic analysis in 23 cases of breast solid papillary carcinoma

作　　者：陈文静[1] 张江宇[1] 陈中扬[2] 吴坤河[1] 郜红艺[1] 林慧娟[1] 王健[1] CHEN Wenjing;ZHANG Jiangyu;CHEN Zhongyang;WU Kunhe;GAO Hongyi;LIN Huijuan;WANG Jian(Pahtholgy Department,Guangdong Province Women and Children Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院广州医科大学附属广东省妇儿医院病理科,广州510010 [2]广东省妇幼保健院广州医科大学附属广东省妇儿医院乳腺科,广州510010

出　　处：《实用医学杂志》2018年第10期1594-1597,共4页The Journal of Practical Medicine

基　　金：广东省科技计划项目(编号:2017ZC0316;2016ZC0186)

摘　　要：目的探讨乳腺实性乳头状癌(SPC)的临床病理特征。方法回顾性分析23例SPC的临床表现、病理形态学和免疫组化的特征及预后随访。结果 23例SPC患者首发症状乳头溢液16例,乳腺肿块7例。超声检查BI-RADS 4级以上占60%(6/10)。钼靶检查BI-RADS 4级以上占61.53%(8/13)。8例SPC伴浸润中Luminal A型5例,Luminal B型3例。原位SPC组和SPC伴浸润组比较,在平均年龄、平均直径、神经内分泌标志物、Ki67及淋巴结转移上差异无统计学意义(P>0.05),而在肌上皮标志物P63和CK5/6上差异有统计学意义(P=0.001、P=0.019)。21例患者随访均未见复发。结论 SPC是一种预后良好且少见的独立亚型的乳腺癌。影像学及乳管镜易漏诊,病理易误诊,临床病理医生应重视更好的精准治疗。Objective To explore the clinical pathological characteristics of breast solid papillary carcino-ma（SPC）. Methods The clinical manifestation,pathology morphology,immunohistochemical characteristics andprognosis of 23 cases with SPC was reviewed. Results There were 16 cases with nipple discharge as the chief com-plaint while 7 cases were mass. 10 cases of ultrasonic examination showed 6 cases（60%）were above BI-RADS grade4 while 8/13 in X-ray examination. In 8 cases of SPC with invasion,5 cases were luminal A and 3 cases were lumi-nal B. There were no significant differences in the mean age,mean diameter of the mass,neuroendocrine markers（Cg A and Syn）and proliferation marker Ki67 between in situ SPC group and invasive SPC group（P〉0.05）.The difference between P63 and CK5/6 was statistically significant（P = 0.001,P=0.019）. No recurrence wasfound in 21 patients. Conclusions SPC is a rare type of breast cancer with good prognosis. Imaging and ductosco-py are easy to make under-diagnosis while pathology is likely to make misdiagnosis,therefore clinical pathologistsshould pay more attention so as to treat it more accurately.

关 键 词：乳腺肿瘤 实性乳头状癌 神经内分泌 免疫表型 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]