乳腺实性乳头状癌临床及病理特征分析

目的探讨乳腺实性乳头状癌(SPC)临床与病理特点、治疗方法。方法回顾性分析2014年1月至2023年12月确诊的28例乳腺SPC患者(原位型9例、浸润型19例)的临床特征、病理形态及免疫组化染色特征。结果28例SPC患者发病年龄29~82岁(中位年龄79岁),临床表现为乳腺肿块和/或乳头溢液。均手术切除,组织学病理:原位型SPC 9例,浸润型SPC 19例。根据肿瘤细胞巢的边缘完整程度分为原位型和浸润型。瘤细胞形态均匀,呈卵圆形或梭形,细胞核为低-中级别。免疫表型,两种类型的肿瘤细胞ER、PR均呈弥漫性强阳(>90%),大多数HER-2表达阴性(92.8%),CgA阳性率35.7%,Syn阳性率96.4%,CD56阳性率平均28.6%,Ki67为1%~40%。结论乳腺SPC好发于老年女性,两种类型SPC的病理特征、免疫表型均具有较大差异。

Objective To explore the clinical and pathological characteristics and treatment methods of solid papillary carcinoma(SPC)of the breast.Methods Retrospectively analysed the clinical features,pathological morphology,and immunohistochemical staining characteristics of 28 breast SPC patients(9 cases of in situ type and 19 cases of invasive type)diagnosed from January 2014 to December 2023.Results The age of onset of 28 SPC patients ranged from 29 to 82 years(median age 79 years),with clinical manifestations of breast masses and/or nipple discharge.Surgical resection was performed on 9 cases of in situ SPC and 19 cases of invasive SPC.According to the degree of edge integrity of tumor cell nests,they are divided into in situ type and invasive type.The tumor cells had uniform morphology,appearing oval or spindle shaped,and the nuclei are of low to medium grade.Immunophenotypes showed diffuse strong positivity(>90%)for ER and PR in both types of tumor cells,with most HER-2 expression negative(92.8%).The average positivity rates for CgA are 35.7%,Syn are 96.4%,CD56 are 28.6%,and Ki67 ranges from 1%to 40%.Conclusion Breast SPC is more common in elderly women.The pathological characteristics and immunophenotypes of the two types of SPC have significant differences.