论文部分内容阅读
目的探讨乳腺恶性叶状肿瘤(PT)的临床病理特征、免疫表型、鉴别诊断和预后相关因素。方法收集2009-01-2016-05间8例乳腺恶性PT的临床病理资料,对其进行光镜观察,采用免疫组织化学En Vision法,将常规形态学特点、免疫表型与随访结果进行关联分析。结果患者年龄15~51岁,肿瘤大小平均5.5 cm(1~8 cm)。组织学上间叶性肿瘤细胞增生明显,多数病例呈梭形细胞肉瘤样分化并可见叶状结构,3例可见异源性成分。间叶性肿瘤细胞Ki-67阳性指数平均值为28.6%。CD34、p16在间叶性肿瘤细胞中的阳性比例分别为1/8、7/8,ER、PR、Her-2均为(-)。随访时间为4~40个月。局部复发4/8例,远处转移2/8例,1例死亡。结论恶性PT较少见,预后较好。有异源性成分出现时预后较差。免疫组化可作为诊断恶性PT的重要辅助指标。
Objective To investigate the clinicopathological features, immunophenotype, differential diagnosis and prognosis of breast malignant leaf tumor (PT). Methods The clinicopathological data of 8 cases of malignant PT were collected from 2009-01-2016-05. The pathological changes of the malignant PT were observed by light microscopy. The En Vision method was used to correlate the morphological features, immunophenotype and follow-up results . Results The patients were 15-51 years old and had an average tumor size of 5.5 cm (1 ~ 8 cm). Histology of mesenchymal tumor cell proliferation was obvious, the majority of cases were spindle cell sarcoma-like differentiation and visible leaf-like structure, three cases showed heterogeneous components. The average Ki-67 positive index of mesenchymal tumor cells was 28.6%. The positive rates of CD34 and p16 in mesenchymal tumor cells were 1/8 and 7/8, respectively. The positive rates of ER, PR and Her-2 were all (-). Follow-up time was 4 to 40 months. 4/8 cases of local recurrence, distant metastasis 2/8 cases, 1 case of death. Conclusion Malignant PT is rare, the prognosis is good. Heterologous components appear poor prognosis. Immunohistochemistry can be used as an important auxiliary indicator for the diagnosis of malignant PT.