乳腺叶状肿瘤伴肿瘤内癌131例汇总分析

Phyllodes tumor of breast with intratumoral carcinoma: an analysis of 131 cases

目的 探讨乳腺叶状肿瘤内癌的临床病理特征、诊断、治疗及预后。方法 报道1例罕见的伴肿瘤内癌的巨大叶状肿瘤,通过常规HE及免疫组织化学染色,并汇总文献报道的130个病例,结合临床特征进行统计分析。结果 叶状肿瘤内癌几乎包括了乳腺癌的所有类型,多数为原位癌,低级别多见,浸润癌以浸润性导管癌为主。恶性叶状肿瘤出现肿瘤内癌的比例更高。预后与叶状肿瘤类型有关,与手术方式及是否追加治疗无关。结论 乳腺叶状肿瘤内的癌的组织形态及免疫表型与非叶状肿瘤内的癌一致;叶状肿瘤间质细胞可能促进了肿瘤内癌的发生,恶性者更容易癌变。

Objective To investigate the clinicopathological features, diagnosis, treatment and prognosis of phyllodes tumor of the breast with intratumoral carcinoma. Methods A rare case of intratumoral carcinoma of giant phyllodes tumor was reported by conventional HE and immunohistochemical staining, and 130 cases reported in the literature were summarized and statistically analyzed in combination with clinical features. Results Intratumoral carcinoma of phyllodes tumor included almost all types of breast carcinoma, most of which were carcinoma in situ, low-grade carcinoma was more commonly reported, and invasive carcinoma was mainly invasive ductal carcinoma. Malignant phyllodes tumors had a higher rate of intratumoral carcinoma. Prognosis was related to the types of phyllodes tumors, not to surgical modalities or whether additional treatment was granted. Conclusion The histomorphologies and immunophenotypes of carcinoma in phyllodes tumor of the breast are consistent with other breast carcinoma. The stromal cells of phyllodes tumor may promote the occurrence of intratumoral carcinoma, and the malignant one is more easily to become cancerous transformation.