44例乳腺实性乳头状癌临床与病理学特征分析

Solid-papillary carcinoma of the breast,an analysis of 44 cases

目的探讨乳腺实性乳头状癌(solid papillary carcinoma,SPC)临床与病理学特征、免疫表型、预后及鉴别诊断要点。方法回顾性研究北京大学人民医院病理科2013年7月至2017年10月乳腺实性乳头状癌44例的病例资料,总结其临床和病理组织学特征。结果44例均为女性,平均年龄66.5岁。17例临床表现为乳头溢液,27例为乳腺肿物。组织病理学特征为实性乳头状结构。细胞呈多边形或卵圆形,常伴黏液分泌及神经内分泌分化。本组44例SPC中22例伴有浸润癌者,15例为非特殊类型浸润性癌成分,组织学分级为Ⅰ~Ⅱ级,7例为黏液癌表现。6例进行乳腺改良根治术,腋窝淋巴结清扫2例可见癌转移,38例分别行保乳术或乳腺全切术;随访时间为12-48个月,其中一例患者因非肿瘤原因去世,其他患者均无瘤生存。结论乳腺实性乳头状癌较少见,好发于老年女性,预后良好。

Objective To investigate the clinicopathological features of solid papillary carcinoma of the breast.Methods A retrospective study was performed to analyze the clinical and histopathologic manifestations in 44 cases of SPC in Peking University People's Hospital from 2013.7 to 2017.10.Results All the patients were female and mean age was 66.5 years.17 cases complained of nipple discharge and 27 cases had breast mass.Pathologically tumors were of solid-papillary growth pattern.The tumor cells were polygonal or oval with mucin production and neuroendocrine differentiation.22 cases were associated with invasive carcinoma,among which 15 cases were non-special invasive carcinomas.7 cases were mucinous carcinoma.Six cases underwent modified radical mastectomy and axillary lymph nodes excision with two metastasis in an axillary lymph node.38 cases underwent breast conserving surgery or mastectomy.There were no local recurrence or distant metastasis during the follow?up periods of 12-48 months.Conclusion Solid papillary carcinoma of breast is a rare pathology type with predilection in older women.The postoperative prognosis is fair.