基底细胞样乳癌临床病理分析

BASAL-LIKE BREAST CANCER:A CLINICOPATHOLOGIC ANALYSIS

目的探讨基底细胞样乳癌(BLBC)的临床病理特征、诊断标准及预后。方法应用免疫组化方法筛选出121例BLBC,检测其雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)、雄激素受体(AR)、表皮生长因子受体(EGFR)和P钙黏蛋白(P-cadherin)的表达,观察和分析BLBC的临床病理组织学特点及预后相关因素。结果 121例BLBC中,76例病人的年龄在50岁以上,75例肿瘤直径大于2cm。肿瘤生长边界呈推挤样,瘤细胞异型性显著(WHOⅢ级86.78%),坏死及间质淋巴细胞反应多见,淋巴结转移率52.89%。AR、ER、PR、HER2的阴性表达率分别为71.07%、73.55%、76.03%和76.86%,而81.81%(99/121)病人P-cadherin阳性表达。结论 BLBC是一种不同于非特殊型浸润性导管癌的乳癌亚型,其特征性组织学形态及免疫组化结果提示BLBC病人的预后较差。

Objective To explore the clinicopathologic characteristics, diagnostic criteria and prognosis of basal-like breast cancer （BLBC）. Methods By using immunohistochemical technique, 121 patients with BLBC were selected, and their ER, PR, HER2, AR, EGFR and P-cadherin were detected and the elinicopathologic features as well as prognosis-concerning factors analyzed. Results Of the 121 BLBC, 76 of them were over 50 years old, the diameter of the cancer of over 2.0 em was recorded in 75 cases. Microscopically, justle-like growth was observed at the margin of the tumor, the cells showed dramatically heteromorphism （86.78%, grade Ⅲ of WHO）, necrosis and stromal lymphocytic response increased, and lymph node metastasis rate was 52.89%. The negative rates of AR, ER, PR and were 71. 07%, 73.55%, 76.03% and 76.86%, respectively, and positive rate of P-cadherin was 81.81%（99/121）. Conclusion BLBC is a subtype breast cancer other than non-special infiltrating ductal carcinoma, its histologic characteristics and immunohistoehemical results suggest that the prognosis of patients with BLBC is poor.