乳腺粘液腺癌23例临床病理研究

Clinicopathological study on 23 cases of mucinous breast carcinoma

目的 探讨乳腺粘液腺癌的临床病理特点。方法 对 2 3例乳腺粘液腺癌进行临床、病理、免疫组化ER、PR、NSE、CgA分析。 结果 ①单纯型 17例 ,混合型 6例 ;②单纯型与混合型的淋巴结转移率 (P <0 .0 1)、5年生存率 (P<0 .0 1)、ER阳性率 (P <0 .0 1)均有显著差异 ;③ 10例单纯型NSE阳性 3例、CgA阳性 1例 ,4例混合型NSE阳性 1例。结论 ①单纯型和混合型有不同的预后 ,淋巴结是否转移和组织学类型是决定预后的重要因素 ;②单纯型粘液腺癌部分可能为原位癌 ;③乳腺粘液癌伴神经内分泌分化的意义有待进一步研究。

ObjectiveTo explore the clinicopathological features of the mucinous breast carcinoma.MethodsThe clinic features,histological type,the lymph node state of 23 cases with mucinous breast carcinoma were analysed.Expression of ER,PR,NSE,CgA was studied immunohistologically (S-P) in 14 cases. ResultsOf the 23 tumors,17 were of the pure type and 6 of mixed type.The rate of lymph node metastases,5-year survival rate and positive rate of ER were significantly different between the patients with pure mucinous carcinoma and the ones with mixed carcinoma(P<0.01).Of the 10 cases with pure mucinous carcinoma 3 were positive with NSE,1 positive with CgA,whereas of the 4 cases with mixed carcinoma,1 was positive with NSE.ConclusionThe prognosis of the pure mucinous carcinoma differs from the mixed carcinoma.The lymph node states and the histological type are major factors to the prognosis of the patients with mucinous breast carcinoma.Some of the pure mucinous breast carcinomas may be carcinoma in situ.The value of mucinous breast carcinoma with neuroendocrine differentiation is worthy of being further studied.