乳腺实性乳头状癌临床病理特征及预后分析

摘要

目的 探讨乳腺实性乳头状癌(SPC)的临床病理特征.方法 回顾性分析23例SPC的临床表现、病理形态学和免疫组化的特征及预后随访.结果 23例SPC患者首发症状乳头溢液16例,乳腺肿块7例.超声检查BI-RADS 4级以上占60%(6/10).钼靶检查BI-RADS 4级以上占61.53%(8/13).8例SPC伴浸润中Luminal A型5例,Luminal B型3例.原位SPC组和SPC伴浸润组比较,在平均年龄、平均直径、神经内分泌标志物、Ki67及淋巴结转移上差异无统计学意义(P>0.05),而在肌上皮标志物P63和CK5/6上差异有统计学意义(P=0.001、P=0.019).21例患者随访均未见复发.结论 SPC是一种预后良好且少见的独立亚型的乳腺癌.影像学及乳管镜易漏诊,病理易误诊,临床病理医生应重视更好的精准治疗.%Objective To explore the clinical pathological characteristics of breast solid papillary carcino-ma(SPC). Methods The clinical manifestation,pathology morphology,immunohistochemical characteristics and prognosis of 23 cases with SPC was reviewed. Results There were 16 cases with nipple discharge as the chief com-plaint while 7 cases were mass. 10 cases of ultrasonic examination showed 6 cases(60%)were above BI-RADS grade 4 while 8/13 in X-ray examination. In 8 cases of SPC with invasion,5 cases were luminal A and 3 cases were lumi-nal B. There were no significant differences in the mean age,mean diameter of the mass,neuroendocrine markers (CgA and Syn)and proliferation marker Ki67 between in situ SPC group and invasive SPC group(P > 0.05). The difference between P63 and CK5/6 was statistically significant(P = 0.001,P = 0.019). No recurrence was found in 21 patients. Conclusions SPC is a rare type of breast cancer with good prognosis. Imaging and ductosco-py are easy to make under-diagnosis while pathology is likely to make misdiagnosis,therefore clinical pathologists should pay more attention so as to treat it more accurately.