43例分泌性乳腺癌临床分析

Prognostic analysis of 43 cases of secretory carcinoma of the breast

目的 探讨分泌性乳腺癌（secretory carcinoma of breast,SCB）的临床病理特征及预后.方法 对43例SCB患者的临床及病理资料进行回顾性分析. 结果 SCB发病率低,约占同期乳腺癌患者的0.17％;中位发病年龄49岁;肿物直径1.0～ 10.0cm,平均最大径为3.2cm;病理学特点：癌细胞内外可见大量嗜酸性分泌物,过碘酸雪夫染色（periodic acid-Schiff,PAS）及阿利辛兰染色（Alcian blue,AB）呈阳性反应;雌激素受体（estrogen receptor,ER）阳性率为34.9％（15/43）、孕激素受体（progesterone receptor,PR）阳性率为23.3％（10/43）,人类表皮生长因子受体2（humanepithelial growth factor receptor 2,HER-2）阳性率为25.6％（11/43）,S-100阳性率为97.7％ （42/43）,PAS及PAS消化（＋）阳性率100％（8/8）.43例患者均接受手术切除.术后平均随访78个月.7例患者发生远处转移（16.3％）,其中2例死亡.结论 分泌性乳腺癌预后较好,但仍可能出现腋窝转移、局部复发或远处转移.

Objective To investigate the clinicopathologic features and prognosis of secretory carcinoma of the breast （SCB）.Methods We enrolled 43 cases of secretory carcinoma of the breast out of invasive breast cancer patients according to the 2012 WHO Classification of Tumors of the Breast.Results The incidence of breast SCB was low,accounting for about 0.17％ of all breast cancer patients.The median age of onset was 49 years old.The diameter of tumor was 1.0-10.0 cm（mean size 3.2 cm）.Pathology revealed large number of eosinophilic secretory material inside or outside the cancer cells positive for periodic acid-Schiff stains （PAS） and Alcian blue （AB）.The positive rate of estrogen receptor （ER） was 34.9％ （15/43）,progesterone receptor （PR） was 23.3％ （10/43）,human epithelial growth factor receptor 2 （HER-2） was 25.6％ （11/43）,S-100 was 97.7％ （42/43）,and special PAS and AB diastase were tested and positive in 8 cases.The postoperative average follow-up time was 78 months,7 cases were found with distant metastasis.2 cases dying of distant metastasis.Conclusions SCB has a good prognosis despite of occasionally axillary lymph node metastasis,local recurrence or distant metastasis.