Purpose To elucidate the clinicopathologic features of encapsulated papillary carcinoma ( EPC ) of the breast. Methods The clinicopathologic features and immunohistochemical results of 17 cases of breast EPC were reviewed. The antibody used for iininu-nohistochemical staining included p63, SMA, CK5/6, ER, PR, HER-2 and Ki-67. Follow-up data for the patients was got. Results Of the 17 EPC patients, 16 were females, with a mean age of 62 years. Palpable mass and nipple discharge were the most common symptoms. EPCs ranged in size from 1. 5 to 5. 5 cm( mean 2. 9 cm ), and 10 cases were cystic. Microscopic examination showed single or multiple lesions surrounded by a rim of fibrous connective tissue. The majority of EPCs demonstrated the classic features of a papillary architecture lined by tall columnar epithelial cells. The minority presented a cribriform or solid glandular pattern. One patient had metastasis carcinoma in 1 axillary lymph node. Myoepithelial cell staining was negative for p63, SMA and CK5/6 within the tumor and at the periphery of the tumor. The tumor cells were positive for ER and PR. Only 1 case showed 2( + ) staining for HER-2, and the rest were negative. The average positive percentage for Ki-67 was 12% . Follow-up was available in 10 cases, and no patient had recurrence , distant metastasis or death. Conclusions EPC lacking a peripheral layer of myoepithelial cells can be regarded as a special type of invasive carcinoma associated with better prognosis, and can be treated like the therapy of DCIS.%目的 探讨乳腺包裹性乳头状癌(encapsulated papillary carcinoma,EPC)的临床病理特征.方法 回顾性分析17例乳腺EPC的临床病理资料和免疫组化染色结果(抗体包括p63、SMA、CK5/6、ER、PR、HER-2和Ki-67),获取随访患者预后信息.结果 17例EPC中女性16例,男性1例,平均年龄62岁.临床以乳腺肿块和乳头溢液为主要表现.肿瘤最大径1.5～5.5 cm(平均2.9 cm),10例肉眼可见囊腔形成.镜下见肿瘤单发或多病灶聚集,肿瘤周围有纤维性包膜.多数EPC以乳头状结构为主,被覆柱状细胞.少数肿瘤伴有筛状、实体结构或以其为主.1例EPC伴有腋窝癌结节.EPC的周缘和乳头轴心均缺乏p63、SMA和CK5/6阳性染色的肌上皮层.肿瘤细胞ER、PR均(+),1例HER-2呈(),其余均(-).Ki-67平均增殖指数为12%.10例随访患者均无局部复发、远处转移和死亡.结论 缺乏周缘肌上皮层的EPC可被视为特殊的浸润癌亚型,其远期预后较好,可参照导管原位癌(ductal carcinoma in situ,DCIS)治疗标准进行临床治疗.
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