乳腺癌肉瘤的临床特点与病理生物学特性

Clinical characteristic of breast carcinosarcoma in pathology and biology

目的探讨乳腺癌肉瘤的临床特点与病理生物学特性,为以手术为主的综合性治疗提供重要依据。方法回顾性分析经手术和病理学证实26例乳腺癌肉瘤的临床资料,并将30例乳腺癌作为免疫表型的对照组,研究该肿瘤的临床特点和病理生物学特性。结果乳腺癌肉瘤中癌成分>50%者占61.54%,同侧腋淋巴结癌转移率达30.77%;肉瘤成分>50%者占38.46%,同侧腋淋巴结内未见癌转Σ。免疫组化癌成分中EMA和CK阳性率均96.15%,P53、ER和PR阳性率分别为53.85%、61.54%和30.77%,Vimentin和S100阳性率分别为19.23%和15.38%。肉瘤成分中Vimentin和S100阳性率分别为96.15%和88.46%,EMA、CK、ER、PR和P53阳性率分别为19.23%、11.54%、7.69%、3.85%和3.85%。P53、ER、PR、Vimentin和S100与对照组差异有统计学意义(P<0.05);EMA和CK与对照组差异无统计学意义。结论乳腺癌肉瘤是由上皮和间叶成分混合而成的恶性肿瘤,因其成分不同,免疫表型差异较大。它具有双重侵袭性和极易复发的生物学特性,手术和放化疗是最佳的综合性治疗方法。

Objective To investigate the clinical pathological and biology features of breast carcinosarcoma, find some important information for integrate surgical treatment. Methods The histopathology and immunophenotype of 26 cases breast carcinosarcoma and 30 cases breast cacinoma were reviewed. Clinical data such as operation, pathological and biology features were studied. Results In all cases, 61.54% of all cases were composed of more than half of carcinoma, with 30.77% of that had axillary lymph nodes metastatic tumor. 38.46% were composed of more than half of sarcoma, 30.77% had axillary lymph nodes metastatic tumor with no axillary lymph nodes metastatic tumor. Immunohistochemistry results showed positive rate of EMA, CK, P53, ER, PR in carcinoma issues were 96.15%, 96.15%, 53.85%, 61.54% and 30.77%. And that of Vimentin and S100 were 19.23% and 15.38%, respectively. The positive rate of EMA, CK, P53, ER, PR in sarcoma issues were 19.23%, 11.54%, 7.69%, 3.85%, 3.85%. And that of Vimentin and S100 were 96.15% and 88.46%, respectively. There was no statistical difference between two groups in the terms of EMA and CK. Conclusions Primary carcinosarcoma of the breast is fountainhead blend of malignant epithelium and phyllodes tumor, which is a sort of invasive malignant tumor with high recurrence. Integrate treatment may be effective.