Study On The Characteristics Of Collagen Fibers And Related Clinical Pathology Of Phyllodes Tumor Of The Breast

BackgroundsPhyllodes tumors of the breast are stroaml tumors that showed curtained intensity of recurrence,making the second most common breast malignant tumors besides breast cancer.Current diagnosis of phyllodes tumors of breast is made mainly by histological features,which,due to stromal heterogenicity and lacking of the assistance of commonly confirmed immunohistochemical and other valid markers,tends to be pathologically underrated and inadequately operated.As the main stromal component,collagen fibers reveal the functional and histological status of tumors,and are closely related with tumor diagnosis,grading,clinical features and prognosis.Collagen fibers are of potential help to grading and diagnosing phyllodes tumors of breast.ObjectiveTo investigate the features and deposition patterns of collagens in phyllodes tumors of the breast,along with the expression levels of relevant markers,a series of cases have been enrolled and followed up,thus aiming to find the orrelations between collagen characteristics and pathological diagnosis.Methods70 cases of phyllods tumours(53 benign,12 borderline,5 malignant)and 8 cases of fibroadenomas that had accepted surgery treatment in Shandong University Qilu Hospital during 1st Jan,2009 to 31st Dec,2016 were collected.The formalin-fixed and paraffin-embedded samples were rediagnosed and carried out Masson Staining,CD34,Ki67 and Collagen I IHC staining.Both the clinical and pathological features were analyzed.ResultsFeatures of collagen deposition and distribution vary between grades:Collagens in benign pt are in thicker continuous bundles with recognizable flow and directions,and a cuffing pattern below the epithelium.Collagens in malignant PT are in thin discontinuous scattering patterns without notable flow of directions.No polarization or cuffing depositions were observed.Collagens in borderline phyllodes tumors showed features between benign and malignant patterns.The intensity of Masson staining and Collagen I IHC staining showed no significant difference.CD34 positive rate is higher in phyllodes tumors than fibroadenomas,and Ki67 expression rate increases according to tumor grading,and expressions of both benign an malignant tumors show significant difference from other grades of tumors.ConclusionStromal collagen features are correlated with grading of phyllodes tumors of the breast judging from Masson Staining,wich is of significant diagnostic value.CD34 expression rate shows diagnositic value in phyllodes tumors,and Ki67 expressions of both benign and malignant phyllodes tumors show significant difference from other grades of tumors.