Invasive micropapillary carcinoma:A distinct type of adenocarcinomas in the gastrointestinal tract

Invasive micropapillary carcinoma (IMPC) is a rare histological type of tumor, first described in invasive ductal breast cancer, than in malignancies in other organs such as lungs, urinary bladder, ovaries or salivary glands. Recent literature data shows that this histological lesion has also been found in cancers of the gastrointestinal system. The micropapillary components are clusters of neoplastic cells that closely adhere to each other and are located in distinct empty spaces. Moreover, clusters of neoplastic cells do not have a fibrous-vascular core. The IMPC cells show reverse polarity resulting in typical ‘’inside-out’’ structures that determines secretary properties, disturbs adhesion and conditions grade of malignancy in gastrointestinal (GI) tract. Invasive micropapillary carcinoma in this location is associated with metastases to local lymph nodes and lymphovascular invasion. IMPC can be a prognostic factor for patients with cancers of the stomach, pancreas and with colorectal cancer since it is related with disease-free and overall survival. The purpose of this review is to present the characterization of invasive micropapillary carcinoma in colon, rectum, stomach and others site of GI tract, and to determine the immunohistological indentification of IMPC in those localization.

MTDH Expression in Invasive Micropapillary Carcinoma of the Breast

OBJECTIVE To clarify the expression of MTDH in invasive micropapillary carcinoma of the breast （IMPC） and analyze the relationship between MTDH expression and clinicalpathologic parameters of the IMPC patietns.

Relationship between Lymphatic Vessel Density and Lymph Node Metastasis of Invasive Micropapillary Carcinoma of the Breast

OBJECTIVE To investigate the relationship between lymphatic vessel density and lymph node metastasis of invasive micropapillary carcinoma (IMPC) of the breast. METHODS The immunohistochemical study for vascular endothelial growth factor-c (VEGF-C), VEGF Receptor-3 (VEGFR-3) and lymphatic vessel density of 51 cases of IMPC were performed, and lymph node metastases were examined by microscopic analysis of these cases. RESULTS In IMPC, VEGF-C was expressed in the cytoplasm and/or on the membrane of the tumor cells, and the expression of VEGF-C showed a positive correlation with lymph node metastasis (P<0.01). Lymphatic vessel density was determined by the number of micro-lymphatic vessels with VEGFR-3 positive staining. Lymphatic vessel density was positively correlated with VEGF-C expression (P<0.01) and lymph node metastasis (P<0.01). The percentage of IMPC in the tumor was not associated with the incidence of lymph node metastasis. The metastatic foci in lymph nodes were either pure or predominant micropapillary carcinoma. CONCLUSION The results suggested that VEGF-C overexpression stimulated tumor lymphangiogenesis, and the increased lymphatic vessel density may be the key factor that influenced lymph node metastasis of IMPC.

Clinical Value Analysis of Ultrasonography and MRI in Diagnosis of Invasive Micropapillary Carcinoma of Breast

Objective:To investigate the diagnostic value of invasive micropapillary carcinoma(IMPC)by ultrasonography and MRI.Method:63 female patients with IMPC were selected,all of which were confirmed by pathological examination,and were assigned to the IMPC group.In the same period,40 patients with invasive ductal carcinoma(IDC group)were selected for diagnostic efficacy control.The efficacy indexes of accuracy,sensitivity,specificity,positive prediction rate and negative prediction rate were 73.0%,65.9%,89.5%,93.5%,46.9%,respectively.The efficiency indexes of accuracy,sensitivity,specificity,positive prediction rate and negative prediction rate of ultrasound combined with breast MRI were 93.6%,93.2%,94.7%,97.6%,85.7%.Ultrasonography combined with MRI has more application value in the diagnosis of IMPC.

Inverted Apical CD24 and Weak EZH2 Expressions Are Phenotypic Characteristics of Pure Invasive Micropapillary Carcinoma of the Breast

Invasive micropapillary carcinomas (IMPC) of the breast account for less than 2% of all breast cancers and have been recently described as luminal B carcinomas. CD24, CD44, ALDH1 and EZH2 are commonly used as stem-cell markers that display differential expression as a function of stage and molecular type, but their pattern of expression according to this rare histological type remains poorly defined and unknown for EZH2. We assessed expression of these markers in a series of 28 micropapillary breast carcinomas and compared the results with those obtained in a series of luminal A (27 cases) and B (34 cases) invasive carcinomas not otherwise specified (IC-NST). CD24 and CD44 were expressed in most cases. However, CD24 was expressed at the inverted apical membrane in 85% of invasive micropapillary carcinoma and at the apical pole of gland-forming cells in 45% of luminal A (p-val = 6.8 × 10-4) and 13% of luminal B cases (p-val = 1.1 × 10-7). ALDH1 was expressed in the stroma in most tumors, but in only 25%, 11% and 15% in epithelial cells of IMPC, luminal A and B IC-NST, respectively. Nuclear expression of EZH2 was not observed in luminal A tumors, and was detected in 35% (12/34) of luminal B carcinomas (p-val = 6.1 × 10-3) and only 4% (1/28) of invasive micropapillary carcinomas. This series shows that invasive micropapillary carcinomas harbor a CD24-positive inverted apical pole associated with weak EZH2 expression, phenotypical characteristics that distinguish this entity from other luminal carcinomas.

sLe^(x) expression in invasive micropapillary breast carcinoma is associated with poor prognosis and can be combined with MUC1/EMA as a supplementary diagnostic indicator

Objective: Mucin 1(MUC1/EMA) and sialyl Lewis X(sLe^(x)) indicate polarity reversal in invasive micropapillary carcinoma(IMPC). The purpose of this study was to evaluate the expression of MUC1/EMA and sLe^(x) and to assess their diagnostic and prognostic value in patients with IMPC.Methods: The expression of sLe^(x) and MUC1/EMA in 100 patients with IMPC and a control group of 89 patients with invasive ductal carcinoma not otherwise specified(IDC-NOS) were analyzed with IHC. Fresh tumor tissues were collected from patients with IMPC or IDC-NOS for primary culture and immunofluorescence analysis.Results: The rate of nodal metastasis was higher in patients with IMPC than those with IDC-NOS, and IMPC cells tended to express more sLe^(x) and MUC1/EMA in the cytomembranes(the stroma-facing surfaces of the micropapillary clusters) than IDC-NOS cells. In IMPC, high cytomembrane expression of sLe^(x), but not MUC1/EMA, indicated poor prognosis. In addition, among the 100 patients with IMPC, 10 patients had sLe^(x)+/EMA-expression patterns, and 8 patients had sLe^(x)-/EMA+ expression patterns. The primary IMPC cells were suspended, non-adherent tumor cell clusters, whereas the primary IDC cells were adherent tumor cells. Immunofluorescence analysis showed that MUC1/EMA and sLe^(x) were co-expressed on the cytomembranes in IMPC cell clusters and in the cytoplasm in IDC-NOS cells.Conclusions: sLe^(x) can be used as a prognostic indicator and can be combined with MUC1/EMA as a complementary diagnostic indicator to avoid missed IMPC diagnosis.

乳腺浸润性微乳头状癌患者的临床病理特征分析

目的 探讨乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)的临床和病理特征。方法 选取2015年3月至2023年3月首都医科大学宣武医院行乳腺癌根治性手术的IMPC患者55例,根据病理诊断学分类中是否伴有其他类型乳腺恶性肿瘤,分为单纯组(n=10)和混合组(n=45),收集并分析患者的临床和病理资料。结果55例患者平均年龄(57.6±12.4)岁,平均肿瘤大小2.0(1.5,3.6)cm,54例(98.2%)患者的免疫组化的雌激素受体(estrogen receptor,ER)和孕酮受体(progesterone receptor,PR)均为阳性,49例(89.1%)患者的人表皮生长因子受体-2(human epidermal growth factor receptor-2,HER-2)阴性。28例(50.9%)存在腋窝转移。25例(45.5%)存在脉管癌栓。与混合组相比,单纯组患者年龄更高[(60.3±17.5)岁比(57.0±11.1)岁],淋巴结转移总数更多[2.0(1.3,3.5)个比1.8(1.5,4.1)个],差异均有统计学意义(P<0.05)。IMPC患者镜下肿瘤细胞呈“桑葚状”细胞团结构,上皮膜抗原(epithelial membrane antigen,EMA)染色呈“极性倒置”特点。结论 IMPC患者淋巴结受累率较高,对于病理结果为IMPC的患者,应严格腋窝评估和清扫,以期为患者带来更大获益。

胃浸润性微乳头状癌临床病理学特征及预后分析

目的探讨胃浸润性微乳头状癌的临床病理学特征及其对患者预后的影响。方法回顾性分析2017年1月—2019年12月本市两所三甲医院收治的胃癌手术治疗患者850例临床资料,其中具有IMPC成分的58例作为IMPC组,随机选取不含IMPC的79例腺癌患者作为对照组(非IMPC组);同时根据微乳头状癌成分比例将IMPC组分为<10%、10%~29%、30%~49%和50%以上四个组别。观察IMPC形态学及免疫组化特征,分析IMPC组和非IMPC组临床病理特征、预后方面的差异,进而分析不同微乳头状癌成分占比对相关临床病理资料及预后的差异。结果胃腺癌病例中IMPC检出率为6.82%(58/850),其中占比<10%者7例、10%~29%者20例、30%~49%者23例和50%以上者8例。典型IMPC癌细胞呈翻转性生长模式,排列呈实性小巢团状或中空小管状,无纤维脉管轴心,周围有宽窄不等的空白间隙;免疫组化标记MUC1、EMA和E-cadherin等可证实。在组织学类型、脉管侵犯、T分期、N分期、M分期比较项中,IMPC组和非IMPC组患者统计学上具有差异(P<0.05);不同微乳头占比组别在上述方面无统计学差异(P=0.700)。胃切除术后IMPC组3年生存率明显低于非IMPC组患者分别为56.9%和88.6%,两组间3年生存率有显著差异(P<0.001)。此外,IMPC患者不同组别(<10%组、10%~29%组、30%~49%组和≥50%组)的3年生存率分别为100%、90%、47.8%和25%,微乳头成分对胃癌患者预后影响具有统计学意义(P<0.001);因此,微乳头成分超过30%,患者生存率明显下降。结论IMPC属于较高恶性程度和侵袭性腺癌亚型,通过观察其形态学及免疫组化特征及比较与临床病理学特征、预后关系,特别是确定微乳头成分阈值30%,可指导临床病理诊断和患者预后评估。

Prognosis of lymphotropic invasive micropapillary breast carcinoma analyzed by using data from the National Cancer Database

Background:Invasive micropapillary carcinoma(IMPC)is an uncommon subtype of breast cancer.Previous studies of this subtype demonstrated a higher propensity for lymph node metastases as compared with invasive ductal carci-noma(IDC).The purpose of the present study was to determine the clinical characteristics,outcomes,and propensity for lymph node metastasis of patients with IMPC of the breast recorded in the National Cancer Database(NCDB).Methods:Records of patients with IMPC diagnosed between 2004 and 2014 were retrieved from the NCDB.Log-rank test was performed to evaluate associations of clinical characteristics with overall survival(OS).Cox proportional hazards model was used to determine variables associated with OS.Results:Overall,2660 patients with IMPC met the selection criteria;the 5-year OS rate was 87.5%and 24.9%of patients had nodal involvement at presentation.Patients with≥4 positive lymph nodes had shorter OS than node-negative patients,whereas patients with 1-3 positive nodes had similar OS to node-negative patients.Age<65 years,receipt of radiotherapy,and estrogen receptor positivity were also associated with prolonged OS.The benefit of radiotherapy was limited to IMPC patients undergoing lumpectomy;there was no benefit for the patients undergoing mastectomy(regardless of nodal positivity/negativity).Conclusions:Favorable prognostic factors of IMPC patients included age<65 years,<4 positive lymph nodes,receipt of radiotherapy,and estrogen receptor positivity.The results presented herein suggest a survival benefit asso-ciated with radiotherapy in IMPC treatment,though this may be limited to the patients treated with lumpectomy.

乳腺浸润性微乳头状癌的MRI和乳腺X线摄影特征分析

目的探讨乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)在磁共振成像(magnetic resonance imaging,MRI)和乳腺X线摄影(mammography,MG)中的影像学特征。方法回顾性收集2017年1月至2023年4月于汕头大学医学院附属肿瘤医院经活检穿刺或手术病理证实的25例IMPC患者的临床资料,所有患者均行MRI检查,其中20例行MG检查,记录并分析患者的影像学特征、组织病理学特征及受体状态。结果25例患者中20例可触及肿物;MRI共检出33个病变,1例患者为非肿块病变,24例患者为肿块样病变。肿块形状以不规则为主,边缘多不规则或毛刺样,表观扩散系数为(0.862×10–3±0.135×10–3)mm2/s;肿块时间-信号强度曲线以平台或流出型为主。MG显示1例患者无异常,19例患者共检出22个病变,肿块形状多不规则,边缘不清或毛刺状,10例患者显示肿块伴有微钙化。乳腺MRI、MG检查分别检出11例、6例淋巴结异常,最终病理显示14例患者发生腋窝淋巴结转移。免疫组织化学结果显示,雌激素受体阳性24例、孕激素受体阳性22例、人类表皮生长因子受体2阳性7例。结论IMPC影像学上多表现为形态不规则、边界不清晰、边缘多毛刺、不均匀强化、软组织肿块伴微钙化,同时腋窝淋巴结转移率高,对IMPC的临床治疗及预后评价可提供重要参考。

乳腺浸润性微乳头状癌的多组学研究进展

浸润性微乳头状癌是一种罕见的乳腺浸润性癌,由于其发病率较低,且通常与其他组织学类型(如浸润性导管癌)同时存在,极易漏诊。浸润性微乳头状癌具有较高的侵袭能力,严重影响患者的生活质量。随着多组学技术的进步,浸润性微乳头状癌的分子机制得到了进一步阐明,越来越多的潜在靶点已经被揭示。本文旨在综述浸润性微乳头状癌的多组学研究进展。

乳腺浸润性微乳头状癌的影像学表现与免疫组化的相关性研究

目的探讨乳腺浸润性微乳头状癌（invasive micropapillary carcinoma,IMPC）的影像学表现、影像学表现与免疫组化的相关性、病理与淋巴结转移的相关性。方法回顾性分析46例IMPC的X线摄影、超声及病理资料。结果IMPC的X线表现以肿块伴钙化型（54.3%）为主,肿块形态不规则（69.7%）或分叶状（18.2%）、毛刺状边缘（48.5%）或边界不清（36.4%）、高密度（81.8%）或等密度（18.2%）,60%以不定形钙化为主。超声表现以肿块型（76.1%）为主,肿块形态不规则（81.4%）或分叶状（14.0%）、边界不清（81.4%）或清楚（18.6%）、95.3%呈混杂回声,纵横比〈1占86%,后方回声可正常（67.4%）或伴声影（32.6%）,RI为0.57-0.90,平均为0.74。ER＋PR＋HER2-阳性率67.4%,在ER＋PR＋的情况下,单纯型IMPC中HER2-46.1%,HER2＋23.1%,混合型IMPC中HER2-75.7%,HER2＋9.1%。乳腺X线摄影中肿块型IMPC HER2-72.7%,HER2＋9.1%,非肿块型IMPC中HER2-53.8%,HER2＋23.1%。IMPC的淋巴结转移率及转移个数与浸润性导管癌相比差异有统计学意义（P〈0.05）。IMPC类型、HER-2表达及肿瘤大小与淋巴结转移率差异无统计学意义（P〉0.05）。结论 IMPC的X线摄影及超声表现符合乳腺恶性肿瘤的特征。IMPC以ER＋PR＋HER2-多见,混合型IMPC中ER＋PR＋HER2-较单纯型IMPC中多见,单纯型IMPC中ER＋PR＋HER2＋较混合型IMPC中多见。乳腺X线摄影中肿块型ER＋PR＋HER2-较非肿块型多见,非肿块型ER＋PR＋HER2＋较肿块型多见。超声检查与免疫组化无明显相关性。IMPC的淋巴结转移率及转移个数较浸润性导管癌高,IMPC类型、HER2表达及肿瘤大小与淋巴结转移率无明显相关性。

CDH17表达及其SNPs在胃癌发生发展中的意义

目的:探讨CDH17表达与胃癌临床病理学特征的关系及其SNPs与胃癌遗传易感性的关系。方法:制作模拟胃癌侵袭转移动态的组织芯片,免疫组织化学SP法检测CDH17蛋白的表达,PCR-LDR技术检测CDH17基因2个SNPs位点rs2514813和rs3214050的多态性并行测序验证。结果:胃癌CDH17表达上调与组织学分化程度呈正相关(P<0.01);肠型胃癌表达高于弥漫型胃癌;随着侵袭过程的进展,黏膜层、肿瘤中央区、侵袭前沿区胃癌的CDH17表达水平呈下降趋势;CDH17表达与胃癌术后生存时间未见明显相关(P=0.209)。胃癌CDH17基因SNP位点rs3214050等位基因C、T频率及CC、CT和TT的基因型频率与对照组相比差异有统计学意义(P<0.01),携带等位基因T的胃癌患者术后生存时间长于CC基因型(P<0.01)。rs2514813位点基因型与等位基因频率与对照组相比无显著性差异(P>0.05)。结论:CDH17表达升高与胃癌腺样结构的维持及进展相关,rs3214050位点为T等位基因者患胃癌风险低且预后好,提示该位点与中国福建汉族人群胃癌的遗传易感性及预后有关。

乳腺浸润性微乳头状癌2例报道并文献复习

目的探讨乳腺浸润性微乳头状癌(IMPC)的病理形态学特点、诊断、鉴别诊断和预后。方法观察和分析2例乳腺浸润性微乳头状癌的病理形态学特征、免疫组化染色表达并进行文献复习。结果2例乳腺IMPC无特殊临床症状及体症。肿瘤细胞团呈实性或管状的微乳头状排列,漂浮于海绵状腔隙内。微乳头缺乏纤维血管轴心,每个微乳头细胞团和周边的纤维组织均存在无细胞的间隙样结构。瘤细胞cerbB-2、bcl-2、CgA和EMA(+)。结论浸润性微乳头状癌是一种少见的特殊类型浸润性乳腺癌,需与普通型浸润性乳头状癌、黏液癌和转移性乳头状癌等鉴别。

不同器官浸润性微乳头状癌形态病理学及基础研究进展

浸润性微乳头状癌是一种少见的具有特殊形态学特征以及高淋巴结转移、高淋巴管浸润等预后不良生物学行为的恶性肿瘤。近年来研究发现其可以发生在不同的器官,包括乳腺、膀胱、肺、唾液腺、腮腺、结肠、胆管、胃和卵巢等,染色体异常在其发生、发展过程中发挥了重要作用。作者综述了各器官浸润性微乳头状癌的形态病理学及基础研究进展。

Hsp27在乳腺浸润性微乳头状癌中的表达及其意义

目的:乳腺浸润性微乳头状癌(IMPC)具有特殊的组织学形态特征及淋巴结转移率高的生物学特性。本研究旨在通过比较蛋白质组学技术筛选,并验证乳腺IMPC与最常见的非特殊型浸润性导管癌(IDC-NOS)间差异表达的蛋白,从蛋白质角度研究探讨乳腺IMPC的特殊组织学形态及生物学行为机制。方法:双向电泳筛选1例乳腺IMPC和1例乳腺IDC-NOS冻存组织的蛋白表达差异点,质谱鉴定其所对应的蛋白质,免疫组织化学染色检测验证其在43例IMPC和30例IDC-NOS组织切片中的表达。结果:筛选出表达稳定差异的蛋白—热休克蛋白27(Hsp27),且Hsp27在IMPC中表达上调。免疫组织化学染色验证了Hsp27主要表达于肿瘤细胞质中,其在IMPC中的表达明显高于IDC-NOS(Z=-3.236,P=0.001),并与ER(r=0.319,P=0.037)及淋巴结转移数(r=0.444,P=0.003)呈正相关,而与患者年龄、病理学分期、PR和HER-2表达无明显相关性。结论:Hsp27在乳腺IMPC中过表达,且与淋巴结转移数呈正相关,提示Hsp27可能在IMPC淋巴结转移以及特殊的病理形态形成中起着重要作用。

乳腺浸润性微乳头状癌临床病理特征及其预后分析

目的：探讨乳腺浸润性微乳头状癌（invasive micropapillary carcinoma,IMPC）的临床病理特征及预后分析.方法：回顾性分析河北医科大学第四医院2009年1月至2011年12月确诊的65例乳腺IMPC患者,采用免疫组织化学法检测上皮膜抗原（ep？ithelial membrane antigen,EMA）表达以确定微乳头成分在肿瘤中所占比例.按微乳头比例≤10%、11%-30%、31%-50%、〉50%将患者分为4组,并同时检测ER、PR、HER-2的表达.Kaplan-Meier单因素生存分析中行Log rank检验,采用多因素Cox风险回归模型行生存时间的影响因素分析.结果：65例乳腺IMPC患者中单纯IMPC 12例,IMPC伴浸润性导管癌46例,IMPC伴其他浸润性癌7例.乳腺IMPC中微乳头比例≤10%组为7.69%（5/65）、11%-30%组为44.62%（29/65）、31%-50%组为26.15%（17/65）、〉50%组为21.54%（14/65）,4组乳腺IMPC患者中淋巴结转移阳性率差异具有统计学意义（P〈0.01）.免疫组织化学法结果显示, ER、PR和HER-2在乳腺IMPC组织中的阳性率分别为76.92%（50/65）、67.69%（44/65）和24.62%（16/65）,差异具有统计学意义（P〈0.05）.Kaplan-Meier单因素分析显示患者生存时间与淋巴结转移数,微乳头比例,脉管瘤栓,ER、PR、HER-2的表达相关（P〈0.05）.结论：淋巴结转移数,微乳头比例,脉管瘤栓,ER、PR及HER-2的表达均与乳腺IMPC的预后相关。

腋窝副乳腺组织发生的浸润性微乳头状癌的临床病理和免疫组织化学研究

目的:研究发生于腋窝副乳腺组织的原发性浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)的临床病理和免疫表型特征。方法:对发生于腋窝的肿物局部广泛切除标本采用组织全切片法取材制片,应用免疫组织化学方法(SP法)检测肿瘤组织中ER、PR、cerbB-2、p53、上皮膜抗原(EMA)、E-钙黏附素、α-连环素和β-连环素的表达。结果:病理组织学发现肿物由IMPC和导管内癌两种成分组成,分别占95%和5%,癌旁可见正常乳腺组织,且与同侧固有乳腺组织间无连续,证实腋窝部肿瘤为副乳腺组织发生的原发性IMPC。肿瘤组织内可见癌侵犯淋巴管,43枚腋下淋巴结中35枚可见转移灶,侵犯到淋巴管内及淋巴结转移灶内的癌组织均与原发灶形态相同。免疫组织化学染色显示肿瘤组织ER和PR阳性,p53和cerbB-2阴性,EMA在肿瘤细胞簇外表面,即面向间质侧呈阳性表达,E-钙黏附素、α-连环素和β-连环素在癌细胞团内的细胞间连接处呈强表达,而癌细胞团的外表面无表达。结论:发生于腋窝副乳腺组织的IMPC临床病理和免疫组织化学特征与原发于乳腺的IMPC特征相同,并具有同样的高侵袭和转移潜能。

乳腺浸润性微乳头状癌的病理及预后分析

目的探讨乳腺浸润性微乳头状癌(IMPC)的病理特征及预后分析。方法对14例IMPC组织标本行组织病理和免疫组化检测,观察其病理改变及预后情况。结果14例IMPC病理组织形态学表现为典型的IMPC病理特征。14例乳腺IMPC的免疫表型为ER、PR、c-erbB-2、EMA、CK7、CD31阳性。IMPC与其他浸润性导管癌相比,易出现淋巴结转移(P<0.01),术后易复发转移(P<0.05)。结论IMPC是一种特殊表型的乳腺癌,具有独特的组织形态学特点、免疫组化特征,易发生淋巴转移,预后差,应作为一种独立的乳腺癌亚型加以重视。

L1-CAM在乳腺浸润性微乳头状癌的表达及其意义

目的:探讨L1细胞黏附分子(L1 cell adhesion molecules,L1-CAM)在乳腺浸润性微乳头状癌(Invasive micropapillarycarcinoma,IMPC)中的表达及其临床意义。方法:应用免疫组织化学SP法,检测97例乳腺IMPC中L1-CAM表达,并以95例浸润性导管癌非特殊型(invasive ductal carcinoma,not otherwise specified,IDC-NOS)作为对照组。分析L1-CAM在IMPC的表达及与临床病理学特征和预后的关系。结果:L1-CAM表达于肿瘤细胞膜及间质中的脉管内皮细胞,在IMPC组主要表达于肿瘤细胞集团内细胞间的相互连接面。L1-CAM在IMPC中的表达率(50.5%)显著高于IDC-NOS组(18.9%),并与IMPC的组织学分级、脉管侵犯、淋巴结转移、间质内脉管的L1-CAM表达及肿瘤细胞的P53表达呈正相关(P<0.05),与ER、PR表达呈负相关(P<0.05)。单因素分析结果显示,IMPC患者中L1-CAM表达阳性患者预后不良。多因素分析结果显示IMPC中L1-CAM表达是影响患者术后生存的独立预后因素。结论:L1-CAM可能在IMPC集团性生长、侵袭、转移中发挥重要作用,可作为IMPC预后预测的标志物及靶向治疗研究的新靶点。