乳腺叶状肿瘤诊断分级的困惑和进展  

Insight into the grading of breast phyllodes tumors

作　　者：王云帆[1] 宗雪 薛卫成[2] Wang Yunfan;Zong Xue;Xue Weicheng(Department of Pathology,Shougang Hospital,Peking University,Beijing 100144,China;Department of Pathology,Peking University Cancer Hospital,Beijing 100142,China)

机构地区：[1]北京大学首钢医院病理科,北京100144 [2]北京大学肿瘤医院病理科,北京100142

出　　处：《中华病理学杂志》2025年第3期219-223,共5页Chinese Journal of Pathology

摘　　要：乳腺叶状肿瘤是一种罕见的纤维上皮性肿瘤,根据其组织学形态特征可分为良性、交界性和恶性3种病理类型,其中恶性叶状肿瘤占比10%~20%,具有局部复发和远处转移能力,因此准确诊断识别恶性叶状肿瘤,使患者初始就诊时能获得合适的治疗方案尤为重要。目前组织学形态是恶性叶状肿瘤唯一的诊断依据,但由于叶状肿瘤本身就是具有重叠组织学特征的连续疾病谱系,而且目前诊断分级采纳的组织学参数众多且其评价具有主观性,病理学家在恶性叶状肿瘤分级方面缺乏一致性,与叶状肿瘤的生物学行为不完全一致。因此现有恶性叶状肿瘤分级标准面临挑战,精准且重复性好的分级值得我们进一步探索。Phyllodes tumors(PT)of the breast is a rare fibroepithelial tumor,which can be divided into benign,borderline and malignant pathological types according to its histological characteristics.Malignant phyllodes tumor(MPT)accounts for 10%-20%of PT and has the ability of local recurrence and distant metastasis.Therefore,accurate diagnosis and identification of MPT are particularly important for patients to obtain appropriate treatment at the initial diagnosis.At present,histological morphology is the only diagnostic basis for MPT.However,due to the fact that phyllode tumor itself is a continuous disease spectrum with overlapping histological features,and the diagnostic classification adopts many histological parameters and their evaluation is subjective,pathologists lack consistency in MPT grading,and the biological behavior of PT is not completely consistent.Therefore,the existing MPT classification standards are facing challenges,and the accurate and reproducible classification is worthy of further exploration.

关 键 词：乳腺肿瘤 诊断 恶性叶状肿瘤 

分 类 号：R73[医药卫生—肿瘤]