22例乳腺化生性癌临床病理特征分析

Metaplastic breast carcinoma:a clinicopathological study of 22 cases

目的探讨乳腺化生性癌(MBC)的临床病理特征。方法回顾22例乳腺化生性癌临床病理资料,分析其大体、光镜及免疫组化特征,并复习相关文献资料。结果22例均为女性,左乳11例,右乳11例,发病年龄35~72岁(中位年龄54岁),肿块最大径1.6~13 cm(平均4.5 cm)。18例行手术治疗,淋巴结转移阳性率61.1%。组织学类型:鳞状细胞癌15例,梭形细胞癌1例,伴间叶分化的癌6例。免疫组化显示,19例ER、PR、HER-2均阴性,3例ER灶状阳性,2例PR灶状阳性,22例CK阳性。结论乳腺化生性癌是一组异质性肿瘤,恶性程度高,预后差,大多数为三阴性乳腺癌,具有独特的免疫表型,与其他肿瘤鉴别困难时,联合免疫组化标记上皮成分(CK)有助于明确诊断。

Objective To investigate the clinicopathological features of metaplastic breast carcinoma.Methods A retrospective study was performed on the clinicopathological data of 22 MBC cases,and the results of gross appearance,microscopic examination and immunohistochemistry were analyzed.The relevant literature was reviewed.Results All cases were female,11 on the left,11 on the right and age ranged between 35 and 72 years(median age 54 years).In those cases,maximum tumor diameter 1.6 to 13 cm(mean 4.5 cm).18 cases were treated with surgery and the positive rate of lymph node metastasis was 61.1%.There were 15 cases of squamous cell carcinoma,1 case of spindle cell carcinoma,and 6 cases of carcinoma with mesenchymal differentiation.Immunohistochemistry showed that 19 cases were negative for ER,PR and Her-2,3 cases were slightly positive for ER,2 cases were slightly positive for PR,and all of cases were positive for CK.Conclusion MBC is a group of heterogeneous tumors with a high degree of malignancy and poor prognosis.Most of them are triple-negative breast cancers with a unique immune phenotype.When it is difficult to distinguish from other tumors,immunohistochemical staining of CK is helpful to clarify the diagnosis.