乳腺腺样囊性癌临床病理特征及预后分析

Clinicopathological features and prognosis of breast adenoid cystic carcinoma

目的探讨乳腺腺样囊性癌(adenoid cystic carcinoma,ACC)临床病理特征及预后。方法回顾性分析34例ACC患者的临床资料及病理特征,并进行生存资料随访。结果 34例ACC患者均以乳腺肿物为首发症状,外上象限肿物共18例(52.9%)。5例同时伴发其他病理类型乳腺癌。5例术中冷冻未确诊,术后病理切片结合免疫组织化学检测确诊为ACC。30例行腋窝淋巴结清扫术,2例出现腋窝淋巴结转移。雌激素受体阴性32例(94.1%),孕激素受体阴性33例(97.1%),HER2阴性34例(100.0%)。2例分别于术后46个月和116个月死于肺转移。结论 ACC多为三阴性乳腺癌,部分病例需要结合病理形态学及免疫组织化学染色确诊,淋巴结转移率低,预后较好。

Objective To analyze the clinicopathological characteristics and prognosis of breast adenoid cystic carcinoma( ACC). Methods The clinical data and pathologic results of 34 ACC patients were retrospectively analyzed. All patients were followed up. Results Breast lump was the first sign of patients,and the lumps were located in the upper outer quadrant in 18 cases( 52. 9%); concomitant cancer of other pathological types were detected in 5 cases. The diagnosis was confirmed by pathological examination and immunostaining in 5 cases whose ACC was not diagnosed in frozen section. Axillary lymph node dissection was performed in 30 patients,while only 2 patients had lymph node metastasis. Thirty-two cases were estrogen receptor negative( 94. 1%),33 cases were progesterone receptor negative( 97. 1%),and all 34 cases were HER2 negative( 100. 0%). Two patients died of lung metastases at 46 and 116 months after the surgery,respectively.Conclusion Most ACC cases are triple-negative breast cancer with low rate of lymph node metastasis and good prognosis.The diagnosis might be missed in frozen section in some cases.