| Objective: To investigate the clinical features,histological changes,immunological phenotypes,therapeutic measures and prognosis of solid papillary carcinoma of the breast(SPC).At the same time,the relationship between mucinous carcinoma and B B-type(BMC)and study the status of HER-2 gene was also studied.Methods: Collect 27 cases of breast SPC cases,summarize its clinical characteristics(including onset age,change of X-ray and ultrasonic changes),using routine HE staining and immunohistochemical staining(IHC),histochemical staining(HC)and fluorescence in situ hybridization(FISH)and to observe the histological changes,immunophenotype and HER2 gene expression status.Results: 27 cases of SPC patients were female,ranging in age from 48 to 80 years old,mean age 67.7 years,which to nipple blood discharge or haemorrhage fluid of 12 cases of disease,the majority of lesions located in around the areola and nipple rear 2 ~ 3cm.4 cases underwent extended resection,2 cases underwent simple mastectomy,10 cases underwent simple mastectomy and axillary sentinel lymph node biopsy,and 11 cases underwent modified radical mastectomy.Microscopic examination of 27 cases of SPC were all tumor cells showed solid proliferation was filled with the entire lumen,the tumor cells have a fine fiber bundle.The tumor cells were arranged in a fence around the bundle of fibers,and the formation of false clusters was seen in some cases.The involvement of the expanding tubes are usually formed round,oval or irregular nodular masses clear boundary.The tumor cells were round,oval,fusiform,polygonal or plasmacytoid,with clear boundaries.27 cases of nuclear grade light to nuclear grade,24 cases of mitotic figures < 5/10 HPF,3 cases of mitotic figures ≥ 5/10 HPF.23 cases showed intracellular and extracellular mucus,24 cases with catheter bleeding,6 cases with acne like necrosis,2 cases with calcification.In 15 cases with invasive carcinoma,1 cases were accompanied with neuroendocrine carcinoma(NEC)and MC;2 cases only accompanied with NEC;4 cases were accompanied with MC;the other 8 patients with minimal invasive carcinoma were in the form of NEC.27 cases were strong expression of ER,PR,3 cases of HER-2 was 2+(including 2 cases with NEC),5 cases were 1+,and the rest were interpreted as: 0.The average positive index of Ki-67 was 9.1%(2% ~20%).The positive expression rates of Syn,Cg A and CD56 in tumor cells were 96.3%(26/27),74.1%(20/27)and 77.8%(21/27).Myoepithelial markers showed 21 cases(77.8%)nests of cells around the myoepithelial partial deletion,4 cases(14.8%)myoepithelial completely missing,2 cases(7.4%)complete myoepithelial around.Expression of CK8/18 in 27 tumor cells was not expressed in CK5/6,and 2cases of CK34βE12 were weakly positive.Tumor cell E-cadherin and P120 were positive in 27 cases.NEC gene amplification in 2 cases with SPC without HER-2.21 patients who underwent axillary lymph node dissection(ALND)axillary lymph node dissection or sentinel lymph node biopsy(SLNB)only 2 cases of metastasis of the cancer,and 2 cases in the primary foci were seen exactly invasive carcinoma component.In this group,25 cases(92.6%)were followed up for 3 to 88 months(average 21.6months),no tumor was found,no tumor recurrence and distant metastasis were found in patients.Conclusion: 1.The main pathologic features of SPC are solid papillary structure with intracellular and external mucus secretion and neuroendocrine markers.2.SPC may be a precursor lesion of the BMC and eversion,containing a large amount of mucus epithelium and mesenchyme fracture formation and mucous spillovers caused by mucous lake formed(the floating clusters of tumor cells)is the development became BMC steps.3.A number of clinical pathological parameters and follow-up showed that SPC has a noble biological behavior and a good prognosis.4.Most cases of SPC cell nests around myoepithelial part or completely missing,suggesting that it may be is a expansion of invasive growth of invasive carcinoma. |
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