目的 分析比较乳腺腺样囊性癌(adenoid cystic carcinoma of the breast,BAdCC)和涎腺腺样囊性癌(salivary glands adenoid cystic carcinoma,SGAdCC)的临床特点、组织形态、免疫表型、生物学行为及预后的异同点.方法 收集8例BAdCC和12例SGAdCC的临床资料,行光镜观察及免疫组化染色,对两组病例进行生存分析.结果 BAdCC患者平均年龄51岁,临床常表现为缓慢的膨胀性生长的肿块,偶伴有疼痛,神经周围浸润不明显,所有病例计56枚淋巴结均未见转移,1例在术后5年复发;SGAdCC患者平均年龄53.5岁,半数患者出现疼痛和麻木,神经周围及邻近骨胳常浸润常见,27枚淋巴结有5枚转移(18.5%),术后短期复发常见,二者的无复发生存率差异有显著性.结论 BAdCC非常罕见,BAdCC与SGAdCC在组织形态和免疫表型上无明显的差异,但二者的生物学行为明显不同,BAdCC呈惰性临床过程,而SGAdCC具有明显的侵袭性,导致这种差异的原因需进一步研究.%Purpose To study and compare the clinical, morphological, immunohistochemical features, biologic behaviors and prognosis of adenoid cystic carcinoma of the breast ( BAdCC ) and salivary glands ( SGAdCC ). Methods Clinicopathologic data of 8 cases of BAdCC and 12 cases of SGAdCC were analyzed. Morphologic observation, immunohistochemistry and survival analysis were performed.Results The mean age of patients of BAdCC was 51 year-old. The main clinical presentation was slow-growing swelling mass which presenting occasionally painful, perineural invasion was not commonly seen. No lymph-nodes metastasis was observed in 56 lymphnodes from all patients. Local recurrence was presented in 1 case at the 5th year after surgery. The mean age of patients of SGAdCC was 53. 5 year-old. Half of SGAdCC presented with pains and numhness. The perineural invasion and bone invasion were commonly seen in these cases. 5 lymph-nodes metastases ( 18. 5 ％ ) were seen in 27 lymph-nodes from all cases of SGAdCC. Recurrences were common in short term after surgery. Survival analysis was remarkahle difference between BAdCC and SGAdCC. Conclusion BAdCC is a rare tumor which is similar to SGAdCC in morphology and immunophotype, but the biologic behavior of BAdCC is different from SGAdCC. BAdCC presents a indolent clinical course while SGAdCC has more aggressive behavior. Why the differences of biologic behaviors between BAdCC and SGAdCC need further study.
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