摘要
目的 探讨乳腺平坦型上皮不典型性病变的形态和免疫表型特征。方法 观察 4 9例乳腺癌和 5例乳腺良性病变中平坦型上皮不典型性病变的HE形态 ,对其中 2 5例进行免疫组化检测 ,选用的一抗有CK8、EMAS 10 0蛋白、SMA、c erbB 2、E cad、PCNA及p5 3,少数病例加做CK(34βE12 )标记 ,1例贴壁性癌加做CK5、bcl 2及GCDFP 15标记。 结果 平坦型上皮不典型病变有以下特征 :①TDLU轮廓保存 ,导 /小管扩张 ,内衬单层或多层有轻重不等不典型性的柱状 /立方上皮 ,常有胞质顶突 ,细胞排列成平坦层状 ,少有向腔内突起 ,腔内可有蓝色絮状物或微小钙化 ,重度病变可有局部的沙丘斑块状突起及少量微乳头。②免疫表型 :柱状细胞表达CK8、EMA ;中 /重度病变表达c erbB 2、E cad ;不表达CK(34βE12 )及CK5 ;PCNA表达率因病变程度而异 ;1例贴壁性癌表达p5 3,部分细胞顶突GCDFP 15阳性 ,bcl 2阴性。③按平坦型不典型病变与癌的关系分为 3组 :Ⅰ组 4 0例 ,两者形态上仅为伴随关系 ;Ⅱ组 5例 ,形态学显示两者间有移行或细胞特征相同 ,提示两者间有内在联系 ;Ⅲ组 4例 ,贴壁性导管原位癌 ,伴小叶内或小叶外微量浸润。结论 平坦型上皮不典型病变中少部分 (本文的Ⅱ、Ⅲ组 )应视为原位癌和 (或 )
Purpose To explore the morphologic and immunophenotypic characteristics of flat epithelial atypia of the breast. Methods Fourty nine cases with mammary carcinoma and 5 cases with benign lesions which had flat epithelial atypia at our institution were selected and studied by light microscopy and immunohistochemistry. Results The characteristics of flat epithelial atypia were presented as follows: ① The architecture of TDLU was maintained. The affected ducts/ductules were variably distended and lined by a single or 3～5 cells layer of variably atypical columnar/cuboid cells often with apical snouts. The cell population linked in the form of stratification of uniform. The distended ducts/ductules may contained blue floccular or secretory material and microcalcifications. Locally mounding or plaque-like areas of epithelium may presented in servere lesion. ② Immunohistochemically, columnar cells were positivitiy for CK8, EMA; In moderat severre lesions, thase columnar/cuboid cells were positive for c-erbB-2, E-cad, and negative for CK(34βE12), CK5; Percentage of positive were variable for PCNA; One case clinging carcinoma in situ were positive for p53 and a few snouts positive for GCDPF-15, but negative for bcl-2. ③ Forty-nine cases were classfied three groups by relationship of flat epithelial atypia and carcinoma: group Ⅰ. Forty cases, there was accompanying relationship; group Ⅱ. Five cases, there were morphological trasitional lesions or same cells between flat epithelial atypia and carcinoma; group Ⅲ, 4 cases, clinging ductal carcinoma in situ, assosiated with infiltration into intra or inter-lobular stroma. Conclusions A few flat epithelial atypia may be lesion of precarcinom.
出处
《临床与实验病理学杂志》
CAS
CSCD
2004年第3期267-272,共6页
Chinese Journal of Clinical and Experimental Pathology
