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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

24卷

期数:

2018年04期

页码:

302-306

栏目:

出版日期:

2018-07-20

文章信息/Info

Title:

Primary breast adenoid cystic carcinoma: a clinicopathological analysis of 27 cases

作者:

李双双; 蒋成英; 付 丽

天津医科大学肿瘤医院乳腺病理研究室，国家肿瘤临床医学研究中心，天津市“肿瘤防治”重点实验室，天津市恶性肿瘤临床医学研究中心，乳腺癌防治教育部重点实验室，天津300060

Author(s):

LI Shuang-shuang;  JIANG Cheng-ying;  FU Li

Department of Breast Pathology and Lab, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratry of Cancer prevention and Therapy(Tianjin), Tianjin’s Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevertion and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China

关键词:

乳腺; 腺样囊性癌; 病理诊断; 治疗; 预后

Keywords:

breast;  adenoid cystic carcinoma;  pathological diagnosis;  treatment;  prognosis

分类号:

R737.9

DOI:

-

文献标志码:

Ａ

摘要:

目的：研究乳腺原发性腺样囊性癌（ACC）的临床病理学特征及预后，为临床治疗方案选择提供依据。方法：分析天津医科大学肿瘤医院乳腺病理研究室1996年6月-2013年8月期间诊断为原发性ACC的27例临床病理学资料及随访信息, 对手术标本采用 HE 及免疫组化染色进行病理学观察，同时进行随访和文献复习。结果：27例乳腺ACC患者(26例女性，1例男性)，中位年龄54岁（39～79岁）。肿瘤平均最大径为2.5 cm（1.2～9.5 cm），其中1例ACC患者出现淋巴结转移（3/13），中位随访时间62个月（3～155个月），无复发、转移及死亡。ACC病理组织学特征表现为癌巢由真、假两种腺腔构成，构成真腺腔的肿瘤细胞CD117染色阳性，而假腺腔则p63、SMA染色阳性。27例ACC的分子分型几乎均为三阴型（不表达ER、PR、HER-2），但Ki67表达较低。结论：乳腺原发性ACC是一种预后较好的三阴型特殊组织学类型乳腺癌，临床处理应区别于其他组织学类型的三阴型乳腺癌。

Abstract:

Objective: To analyze the clinicopathologic features and prognosis of primary breast adenoid cystic carcinoma and to provide basis for clinical therapeutic schedule. Methods: The clinicopathologic data and prognosis information of 27 cases of primary breast adenoid cystic carcinoma diagnosed in Department of Breast Cancer Pathology were reviewed and an objective analysis was made. HE staining and immunohistochemistry was carried out and the literature was also reviewed. Results: The median age of the 27 cases（26 females and 1 male）was 54 years (39 to 79y). The average tumor size was 2.5 cm (1.2 to 9.5 cm) and one had lymphatic metastasis (3/13). The median follow-up time was 62 months (3 to 155m), with no recurrence, distant metastasis or death. Neoplastic cells were polarized around two types of structures: true gland spaces and pseudo lumina. Luminal epithelial cells were usually CD117 positive, pseudo lumina was always p63 and SMA positive. Immunohistochemistry showed that almost all breast adenoid cystic carcinoma was triple-negative subtype which seldom expressed ER, PR and HER-2，but their Ki-67 level was relatively lower. Conclusion: Primary ACC is a special histological type of triple-negative breast cancer (TNBC) which has an excellent prognosis and its clinical procedures should differ from other types of TNBC.

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更新日期/Last Update: 2018-07-20