乳腺导管内乳头状病变的病理分析

Pathological Analysis of Intraductal Papillary Lesions of the Breast

目的乳腺导管内乳头状病变的病理分析。方法选取2018年6月至2019年6月至我院诊治的83例乳腺导管内乳头状病变患者进行回顾性分析,对其病理情况进行分析,主要是了解患病类型,病理组织观察结果,以及免疫组化基因表达情况。结果83例乳腺导管内乳头状病变患者中,导管内乳头状瘤69例,导管内乳头状癌9例,实性乳头状癌5例;病理组织观察结果,肉眼下可见切面结节、颜色呈粉灰色、边缘推挤的案例明显较多,光镜下显示细胞为圆形、或卵圆形、核染色质细腻,腺上皮为多层且具有纤维轴心的乳头状结构的案例较多,数据差异有统计学意义(P<0.05);免疫组化基因表达情况,CK5/6多表达为阳性,CK8阳性表达逐步下降,数据差异有统计学意义(P<0.05),ER在正常导管上皮及肿瘤上皮可见阳性(P=0.001),而P63阴性表达数量略多于阳性,差异无统计学意义(P>0.05)。结论在乳腺导管内乳头状病变患者中,多数为乳腺导管内乳头状瘤,属于良性病变,在组织观察结果上,患者组织可以观察到明显的异常,在免疫组化表达上,其蛋白表型表达情况也有明显差异,临床上可以参考相关数据对疾病进行诊断。

Objective To analyze the pathology of intraductal papillary lesions of the breast.Methods 83 patients with intraductal papillary disease of the breast who were diagnosed and treated in our hospital from June 2018 to June 2019 were selected for retrospective analysis,and their pathological conditions were analyzed,mainly to understand the disease type,pathological observation results and immunohistochemical gene expression.Results Among the 83 patients with intraductal papillary lesions,69 had intraductal papilloma,9 had intraductal papillary carcinoma and 5 had solid papillary carcinoma.Histopathologic observations,visible to the naked eye under section pushing the edge of the gray nodules,color powder,clear case is more,then a display cell of round or ovoid,nuclear chromatin is exquisite,glandular epithelium for multilayer with papillary structure of the fiber axis of case is more,the data was statistically significant difference(P<0.05);In terms of immunohistochemical gene expression,the majority of ck5/6 expressions were positive,and the majority of CK8 positive expressions were decreasing,with statistically significant differences(P<0.05).ER was positive in normal ductal epithelium and tumor epithelium(P=0.001),while P63 negative expression was slightly more than positive,with no statistically significant difference(P>0.05).Conclusion In patients with breast intraductal papillary lesions,most for breast intraductal papilloma,belong to benign lesions,observations on the organization,the organization can be observed in patients with obvious exceptions,on the immunohistochemical expression,its protein phenotypic expression also have obvious difference,can refer to relevant clinical data for disease diagnosis.