乳腺实性乳头状癌中MUC系列的表达及意义  

Expression of MUC series in solid papillary carcinoma of breast and their significance

作　　者：张小鹰 王浩 韩靖 郭明星 梁春燕 李雪 余斯曼 ZHANG Xiao-ying;WANG Hao;HAN Jing;GUO Ming-xing;LIANG Chun-yan;LI Xue;YU Si-man(Department of Pathologyy Panyu Central Hospital,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中心医院病理科,广州511400

出　　处：《诊断病理学杂志》2022年第5期407-411,共5页Chinese Journal of Diagnostic Pathology

基　　金：广州市卫生健康科技西医类一般引导项目(20211A011118);广州市番禺区科技计划一般医疗卫生项目-基础医学研究类(2020-Z04-020)。

摘　　要：目的 探讨乳腺实性乳头状癌(SPC)免疫组化MUC系列染色表达情况与临床病理特征的关系。方法 收集24例SPC患者的临床病理学资料,观察光镜形态学、免疫组织化学染色,特殊染色。并与DCIS、导管内乳头状瘤伴DCIS进行对比,分析MUC系列染色表达情况。结果 24例SPC中,年龄32~82岁(平均年龄68岁,中位年龄71岁),肿瘤直径1~3 cm,平均1.8 cm。镜下形态:原位SPC病变导管膨胀性扩张形成圆形界限清楚的结节状团块。肿瘤细胞呈实体性增生充填整个导管腔,瘤细胞间有不明显的纤维血管轴心,轴心周围细胞呈栅栏状排列或围绕轴心形成假菊形团。浸润性SPC缺乏肌上皮细胞并有不规则的轮廓,并在结缔组织间质中形成地理拼图模式,以及不规则实性乳头状巢浸润脂肪组织。免疫表型:ER、PR呈80%~100%强阳性,阳性率100%,HER-2均阴性,Ki-67为5%~35%。SPC、DCIS和导管内乳头状瘤伴DCIS三者MUC系列表达情况:MUC1在三者中均出现弥漫胞质阳性及腔缘阳性;70.8%的SPC中含黏液细胞胞质(包括印戒样细胞)表达MUC2,分布情况与黏液卡红染色和AB染色阳性细胞一致,而对照组均不表达MUC2;MUC4在SPC中显示局灶或部分区域胞质阳性,阳性率为62.5%,导管内乳头状瘤伴DCIS显示局灶胞质阳性,阳性率为40%,DCIS为阴性;MUC5AC在三者中均表现阴性;MUC6在SPC中显示弥漫性中至强的胞质阳性,阳性率为87.5%,而对照组均显示阴性。结论 MUC2、MUC6联合CK5/6、P63、CgA、Syn、CD56、ER、PR等染色使用有助于SPC的诊断。Objective To explore the relationship between the expression of immunohistochemical MUC series staining and clinicopathological characteristics in solid papillary carcinoma(SPC). Methods The clinicopathological data of 24 patients with SPC were collected, and the morphology, immunohistochemical staining, and special staining were observed. Compared with DCIS and intraductal papilloma with DCIS, the expression of MUC series staining was analyzed. Results Among the 24 cases of SPC, the age was 32-82 years(average age was 68 years, median age was 71 years), and the tumor diameter was 1 to 3 cm, with an average of 1.8 cm. Microscopically, SPC was characterized by expansile nodules with a solid growth pattern and inconspicuous delicate fibrovascular cores. The cells around the cores were arranged in a fence or a pseudo-chrysanthemum cluster. SPC with invasion was diagnosed when the nodules were devoid of a myoepithelial cell layer and had ragged contours creating a geographical jigsaw pattern within a desmoplastic stroma. Fat infiltration by irregular solid papillary nests and breast parenchyma invasion were also seen in these invasive cases. Immunophenotypically, ER and PR were 80%~100% strongly positive;HER-2 was all negative;Ki-67 index was about 5%~35%. The expression of MUC series of SPC, DCIS and intraductal papilloma with DCIS was that MUC1 was diffuse cytoplasmic positive and luminal margin was positive in all the three markers;70.8% SPC tumor cells containing mucin vacuoles(including signet-ring cell) expressed MUC2, and the distribution was consistent with the positive cells stained with mucicarmine and AB staining, while control group was negative;MUC4 showed focal or partial cytoplasmic positivity in SPC and the positive rate was 62.5%. Intraductal papilloma with DCIS showed focal cytoplasmic positive, and the positive rate was 40%. DCIS was negative;MUC5 AC was negative in all three;MUC6 showed diffuse medium to strong in SPC tumor cell cytoplasm, with a positive rate of 87.5%, while control group was neg

关 键 词：乳腺 实性乳头状癌 乳头状 原位癌 MUC 病理学特征 

分 类 号：R730.267[医药卫生—肿瘤]