乳腺包裹性乳头状癌12例临床病理特征分析  

Encapsulated papillary carcinoma of the breast:A clinical and pathological analysis of 12 cases

作　　者：雷建园[1] 陈琳[1] 李文生[1] 刘洁[1] 王萍[1] LEI Jian-yuan;CHEN Lin;LI Wen-sheng;LIU Jie;WANG Ping(Department of Pathology,Shaanxi Provincial People’s Hospital,Xi an 710068,China)

机构地区：[1]陕西省人民医院病理科,西安陕西710068

出　　处：《诊断病理学杂志》2025年第1期23-26,99,共5页Chinese Journal of Diagnostic Pathology

基　　金：西安市科技计划项目(编号:24YXY0163)。

摘　　要：目的探讨乳腺包裹性乳头状癌(EPC)的临床病理特点、诊断与鉴别诊断及预后。方法回顾性分析12例EPC的临床资料,总结其病理学特征、免疫表型和预后,并复习相关文献。结果患者女性11例,男性1例,年龄34~84岁,平均年龄64岁,肿瘤最大径约1~6.8 cm,平均直径3.2 cm。镜下示纤维性包膜内肿瘤细胞呈乳头状、筛状排列,低-中级别核异型,2例呈大汗腺分化。免疫组化示ER(10/12)、PR(10/12)、AR(5/8)、GCDFP15(1/1)阳性,纤维性包膜及乳头轴心肌上皮标记均阴性。诊断单纯性EPC 2例,EPC伴导管原位癌(DCIS)4例,EPC伴浸润6例。随访期间均未见复发或转移。结论EPC好发于老年女性,生物学行为惰性,常伴有DCIS或浸润,其中大汗腺型EPC罕见,准确诊断需在充分取材的基础上结合形态学特点、免疫组化综合判断。Objective To investigate the clinicopathological features,diagnosis,differential diagnosis,and prognosis of encapsulated papillary carcinoma(EPC)of the breast.Methods Retrospective analysis of the clinical data of 12 cases of EPC was conducted to summarize its pathological features,immune phenotype,and prognosis,and review relevant literature.Results There were 11 female and 1 male,aged 34-84 years(median 64 years).Diameter of tumors was from 1 cm to 6.8 cm(median 3.2 cm).Microscopically,the tumor cells within the fibrous capsule were arranged in papillary and cribriform patterns,with low to moderate nuclear atypia,and 2 cases showed apocrine differentiation.Immunohistochemistry showed positivity for ER(10/12),PR(10/12),AR(5/8),and GCDFP15(1/1),while the capsule wall and intramural myoepithelial markers were negative.There were 2 cases of pure EPC,4 cases of EPC with ductal carcinoma in situ(DCIS),and 6 cases of EPC with invasion.No recurrence or metastasis was observed during the follow-up period.Conclusion EPC predominantly occurs in elderly women,with indolent biological behavior,often accompanied by DCIS or invasion.Apocrine EPC is rare.Accurate diagnosis requires comprehensive judgment based on adequate sampling,morphological characteristics,and immunohistochemistry.

关 键 词：包裹性乳头状癌 大汗腺型 乳腺 病理 

分 类 号：R737.9[医药卫生—肿瘤]