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 fibrousvascular 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 diseasefree 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.

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。

乳腺单纯型浸润性微乳头状癌的超声与病理学特征的相关性研究

目的:研究乳腺单纯型浸润性微乳头状癌(pure invasive micropapillary carcinoma,PIMPC)的超声特征及其与病理学特征的相关性。方法:选取2010年1月-2016年5月于深圳市龙华区人民医院行手术治疗且术后病理学检查证实为PIMPC的47例患者为研究对象,同期选取乳腺单纯型浸润性导管癌(invasive ductal carcinoma,IDC)患者40例为对照组,观察并比较PIMPC与IDC的超声表现,评价超声在PIMPC腋窝淋巴结转移中的应用价值。结果:两组之间患者年龄、病灶大小、病灶位置及病灶分布等差异无统计学意义(P>0.05),而病灶直径、边缘毛刺、边缘蟹足状改变、内部回声、后方回声、纵横比、Alder血流分级及超声弹性成像评分差异有统计学意义(P<0.05)。以术后病理学检查结果为金标准,超声诊断PIMPC腋窝淋巴结转移的灵敏度、特异度、阳性预测值和阴性预测值分别为52.94%、76.92%、85.71%和38.46%。结论:PIMPC超声表现主要为形态不规则、边界不清、边缘毛刺及低血流信号,与乳腺肿瘤组织病理学特征密切相关。此外,超声对提示PIMPC腋窝淋巴结转移具有一定价值。