乳腺癌患者皮肤微转移灶的临床意义

Nipple-skin micro-metastasis in breast cancer patients

目的探讨检测乳腺癌患者皮肤微转移灶的临床意义。方法从皮肤距肿瘤最近点及乳头乳晕复合体正中切面取材,分别进行常规病理及细胞角蛋白单抗免疫组织化学法 (immunohistochemistry,IHC)检测60例乳腺癌患者标本。结果60例乳腺癌中,常规病理检测出有乳头乳晕复合体浸润的3例(占5．0％),IHC检测出7例(占11．7％),两者间有统计学意义(x2= 2．25,P<0．05);常规病理检查及IHC法均检测出4例有皮肤浸润(占6．7％)。其中3例两种方法均证实皮肤和乳头乳晕复合体同时有癌浸润。结论IHC对乳头乳晕复合体的微转移灶的检出率高于常规病理,皮肤及乳头的受累率较低,如无受累,可行保留皮肤的乳房切除术。

Objective To explore the clinical significance of micro-metastasis （mM） in the nipple-areola complex （NAC） and the regional skin of breast cancer. Methods Samples from the skin projection of the lump and the midline-transection of the nipple-areola complex were collected from 60 breast cancer patients for both routine pathological examination （RP） and cytokeratin-19 （CK-19） monoclonal antibody immuneohistochemical examination （IHC）. Results NAC invasion was identified by RP in 3 cases （5.0%）, and by IHC in 7 cases （11.7%） （X^2 =2.25,P 〈0.05）, while skin invasion was identified in 4 cases （6. 7% ） by both methods. Three cases of simuhaneous invasion to the local skin and the NAC were identified by both methods. Conclusions IHC is more sensitive in detecting NAC mM than RP, it was found that the incidence of NAC-skin mM of breast cancer was relatively low, and skin-sparing mastectomy is applicable if no skin invasion is identified.