乳腺神经内分泌癌的临床病理学特点  

Clinicopathologic characteristics of primary neuroendocrine carcinoma in breast

作　　者：皋岚湘[1] 丁华野[1] 李琳[1] 张建中[2] 

机构地区：[1]北京军区总医院病理科,北京100700 [2]解放军306医院病理科,北京100101

出　　处：《临床与实验病理学杂志》2003年第3期236-241,共6页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的　探讨具有神经内分泌特征乳腺癌的临床病理特点 ,加深对其认识。方法　观察 5例乳腺神经内分泌癌的组织学特征并进行免疫组化染色 ,判定标准为≥ 5 0 %肿瘤细胞表达Syn、CgA或NSE。 结果　 4例女性 ,1例男性。年龄 5 4～ 90岁(平均 70岁 )。肿瘤直径 2 5～ 5 5cm(平均 3 5cm)。有淋巴结转移者 2例。组织学形态包括富于细胞的黏液型、实性岛状型、弥漫实性粘附型、非典型类癌型和小细胞癌型。 5例均表达Syn、CgA、NSE、AE1/AE3和EMA ;2例表达Lue 7,2例表达CK7;3例表达E cad ;S 10 0蛋白均阴性 ,2例ER和PR阳性 ,3例 p5 3阳性 ,1例表达c erbB 2 ,4例表达bcl 2 ,Ki 6 7阳性率17%～ 85 %。随访时间 4～ 6 9个月 (平均 32 2个月 ) ,除小细胞癌患者死亡外 ,均存活。结论　乳腺神经内分泌癌易发生在老年人 ,除小细胞癌外其他类型预后较好 ,它们在形态、功能和表型上常呈多向性 ,应该将它们从普通型的乳腺癌中区分出来。Purpose To analyse the clinical and pathological characteristics of breast carcinoma with neuroendocrine differentiation for well understanding those breast tumors. Methods The histopathological features were observed and the phenotype were immunohistochemically studied in 5 cases of breast neuroendocrine carcinoma, defined as positive reactivity of ≥50% tumor cells for neuroendocrine markers (synaptophysin, CgA or NSE). Results The patients, who ranged in age from 54 to 90 years (mean 70), were 4 women and one man. The size of tumors was 2.5～5.5 cm (mean 3.5cm) in diameter. Two had metastasis in axillary lymph nodes. The morphological types of these tumors were cellular mucinous, solid insular, solid cohesive, atypical carcinoid and small carcinoma, respectively. All cases were positive for synaptophysin, CgA, NSE, AE1/AE3 and EMA, 3 for E-cadherin, 3 for Lue-7 and CK7, none for S-100, 4 for bcl-2, 2 for ER and PR, 4 for p53, one for c-erbB-2, and Ki-67 staining scores ranged from 17%～85%. The four cases were well but one (small carcinoma) dead with following up 4～69 months(mean 32.2 months). Conclusions These findings suggest that breast neuroendocrine carcinoma, which is often found multidirectional differentiation in morphology, function and phenotype, mainly occurs in elderly patients, and their prognosis is better but small carcinoma,so they should be differentiated from carcinomas of the usual type in breast.

关 键 词：乳腺神经 内分泌癌 临床症状 病理学特点 免疫表型 乳腺肿瘤 

分 类 号：R737.9[医药卫生—肿瘤]