乳腺增生症的病理组织形态及其分类的再探讨

A study on histopathology and classlfication of hyperplastic disease of breast

本文报告３００例乳腺增生症病理形态学分析。将乳腺增生症分成为单纯性增生及非典型增生两大类。前者包括４组病变，后者分成３级。观察结果认为该病为多种病变组合，以２～３种病变者居多（占７４．３％），多者达到７种，平均２．６种。与美国妇女比较，中国妇女病变中形成囊肿者及大汗腺化生者似较少，非典型增生发生率亦低，小叶非典型增生极少见，而纤维腺瘤变者较多见，发生率达３２．７％。分析乳腺增生症发病年龄，手术时病人年龄以纤维腺病变病人最年轻（年龄高峰为２０～３０岁年龄组），一般增生病变年龄高峰在２５～４０岁年龄组之间，而非典型增生病例则多在４０～６０岁之间。结论认为，将乳腺增生症分为单纯性及非典型增生两大类是可行的，形态学标准易于掌握，与Ｐａｇｅ分类无矛盾，与乳腺癌的发生密切相关。

patients with hyperplastic disease of breast were studied histopathologically. The lesion was divided into 2 categories, i. e. simple and atypical hyperplasia, the former including 4 types of the lesion and the latter being divided into 3 grades. This study demonstrated that the hyperplastic disease of breast is composed of multiple types of the lesion, usually it contains 2-3 types (74. 3% cases), at most 7 and the average 2. 6 types. In the comparison of the lesion between American and Chinese women, there are significant differences. In Chinese women, the rates of occurrence of cystic formation, apocrine metaplasia and atypical proliferation seem to be lower, especially lobular atypical hyperplasia(AH) being much less, while the rate of fibroadenoma is higher (32. 7%). The ages of patients at the breast operation were analyzed. The patients suffering from fibroadenoma were the youngest, their peak ages being in 20-30 year group, those of the patients with mild hyperplasia were in 25-40,and those with atypical hyperplasia in 40-60. It is concluded that the division of hyperplastic disease of breast into 2 categories is practicable, because it provides definite morphological criteria for diagnosis, coordinating with Page's classification, and is closely related to the development of carcinoma of breast.