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1、乳腺微浸润性癌13例临床病理分析【摘要】目的:总结分析乳腺微浸润性癌(MBC)的临床病理学特征、诊断及预后。方法:回顾性分析总结2009-2015年笔者所在医院的13例乳腺MBC的临床资料,观察其组织病理学特点并对部分病例重做免疫组化。结果:13例乳腺MBC中,最大浸润灶直径均彡1mm,伴随原位癌中9例为高级别导管原位癌,3例为中级别导管原位癌,1例为低级别导管原位癌;免疫组化:ER/PR(强阳性〉75%)4例,ER/PR(-)7例,IIER-2(3+)7例,HER-2(2+)4例,HER-2(-)2例,肌上皮标记物P63、CK5/6、Calpo
2、nin原位部分为阳性,浸润部分均为阴性。结论:乳腺MBC是一种比较少见的乳腺癌,WHO(2012)乳腺肿瘤分类规定:以乳腺间质中出现单个或多个独立的显微镜下浸润灶为特征,每个病灶大小均<1mm为诊断标准。免疫组化肌上皮标记物有助于诊断及鉴别诊断。本病很少发生复发及转移,有较好的预后。【关键词】乳腺;微浸润癌;导管原位癌;病理诊断分类号R737.9文献标识码B文章编号1674-6805(2016)22-0101-03[Abstract]Objective:Tosummarizeandanalyzetheclinicalandpathological
3、features,diagnosisandprognosisofmicroinvasivebreastcarcinoma(MBC).Method:Theclinicaldataof13casesofbreastMBCinourhospitalfrom2009to2015wereanalyzedretrospectively,thehistopathologicalfeaturesofthebreastwereobservedandsomecasesweretreatedwithimmunohistochemistry.Result:13cases
4、ofbreastMBC,maximuminfiltrationoftumordiameterwaslessthanorequalto1mm,withcarcinomainsituin9casesofhighgradeductalcarcinomainsitu,3caseswereingradeductalcarcinomainsitu,1caseoflowgradeductalcarcinomainsitu.Immunohistochemistry:ER/PR(stronglypositive>75%)in4cases,ER/PR(-)in7ca
5、ses,HER-2(3+)in7cases,HER-2(2+)in4cases,HER-2(-)in2cases,myoepithelialmarkersP63,CK5/6,Calponininsituwaspositive,infiltrationpartwasnegative.Conclusion:MBCofbreastisararebreastcancer,WHO(2012)breasttumorclassificationrules:inmammarystromaappearedsingleormultipleindependentmic
6、roscopicinvasivefociwerecharacterizedandthesizeofeachlesionwerelessthanorequalto1mmfordiagnosticcriteria.Immunohistochemicalmyoepithelialmarkersarehelpfulforthediagnosisanddifferentialdiagnosis.Recurrenceandmetastasisofthediseaserarelyoccur,thereisagoodprognosis.【Keywords]Bre
7、ast;Microinvasivecarcinoma;Ductalcarcinomainsitu;PathologicdiagnosisFirst-author^saddress:ShunyiDistrictMaternalandChildHealthCareHospitalofBeijing,Beijing101300,Chinadoi:10.14033/j.cnki.cfmr.2016.22.053乳腺微浸润性癌(microinvasivebreastcarcinoma,MBC)是一种比较少见的乳腺癌,是病理诊断中的难点,诊断重复性较差。有关
8、乳腺MBC的诊断标准、临床治疗及预后目前存在诸多争议。本文收集笔者所在医院7年来收治的13例乳腺MBC临床病理资料,结合有关文献,对其临