160例乳腺癌根治术后标本及病理切片分析

Clinicopathological features of 160 cases patients with radical mastectomy

目的:观察160例乳腺癌根治手术标本乳腺内病变和腋窝淋巴结转移情况。方法:肿瘤、腋窝淋巴结及切缘常规取材,另外在肿瘤相邻象限和对角象限的乳腺组织分别取材,同时检测肿瘤HER2基因表达情况。结果:160例乳腺癌均为浸润癌,其中浸润性导管癌92例,浸润性小叶癌48例,髓样癌20例。其中,6例为多发病灶,4例在肿瘤象限外发现微转移灶(直径<2mm),12例有小叶非典型增生。淋巴结转移病例中,8例出现跳跃式转移,分别为后组、肌间组转移。结论:乳腺癌的区域淋巴结转移与肿瘤HER2阳性表达密切相关,由于存在肿瘤象限外的区域微转移灶或小叶的非典型增生、腋窝淋巴结出现跳跃式转移等风险因素,对于临床需要保乳治疗的病例,应该严格控制适应证,充分考虑出现转移的风险因素,确保手术的安全范围。

Objective： To observe the intra-mammary lesions and the metastases to axillary lymph node in 160 cases patients with radical mastectomy. Methods： Tumor, axillary lymph node and surgical margin were routinely sampled. Both the adjacent and the opposite quadrants were sampled simutaneously. HER2 expression of each samples were evaluated. Results： 160 specimen of mammary infiltrative carcinomas were comprised of 92 infiltrative ductal carcinomas, 48 infiltrative lobular carcinomas and 20 medullary carcinomas. Among these, 6 cases were multiple lesions, 4 cases were found micrometastsis （d 〈 2 mm）, 12 cases were combined with lobular dysplasia, 8 cases were revealed jumping-metastasis to lymph nodes. Conclusions： There is intimatecorrelation between HER2 expression and regional lymph node metastasis. Indication of conservative surgery should be extensively controlled because of the exsistence of micrometastasis, lobular dysplasia or jumping-metastasis. Risk factors should be fully considered to ensure the safety of operation.