Comparative Analysis Between Juvenile Fibroadenoma And Phyllodes Tumor Of The Breast

Objective:To investigate the clinicopathological features of juvenile fibroadenomas and phyllodes tumors of the breast and analyze the significant indexes in the pathological featuresMethods: A retrospective analysis was performed on the pathological database of Yijishan hospital of Wannan Medical College,from January 2012 to December2018,took place in adolescent female fibroepithelial tumor,fibroadenomas cases screened women under the age of 20,epithelial and mesenchymal cells rich juvenile fibroadenomas(JFAs)103 cases,and 219 cases of phyllodes tumors(PTs)were screened out,including 159 cases of benign phyllodes tumors(BPTs),45 cases of borderline phyllodes tumors(Bo PTs)and 15 cases of malignant phyllodes tumors(MPTs),at the same time,5 normal breast tissues were selected as the control group,patients were recorded according to their age,tumor size,tumor location,tumor number,and history of recurrence.Histological observation and immunohistochemical correlation between the two groups were conducted,and the immunohistochemical correlation between different grades in the PTs group was also conducted.Statistical software was used to analyze whether there were statistically significant differences between the two groups and within the PTs group.Results: Epithelial cells and stromal cells proliferated in JFAs,zonal phenomenon,leaflike structure,stromal cell atypia,mitotic image,etc.JFAs epithelial cells or stromal cell hyperplasia is apparent,the stroma between the glands arrangement is evener,mesenchymal cells arranged evenly,beam or mesh,mesenchymal cells spindle,part assumes the circular,ovoid,with no or mild atypia,ductal epithelial hyperplasia still are arranged double,14 cases of epithelium is usual ductal hyperplasia(UDH),7 cases of stromal hyperplasia of epithelial cells in fracture surface coating double,formation and leaf lobulated structure similar to that of the tumor,40 cases of interstitial a myxoid,11 cases of interstitial with collagen,2 cases with large sweat gland metaplasia,3 cases of interstitial collagen with small blood vessels,pseudoangiomatous stromal hyperplasia(PASH),6 cases of stromal cells mild atypia,fission like number 1-2 /10 HPF,7 cases of visible zoning phenomenon.The fissure-like epithelial cells on the surface of PTs form interstitial hyperplasia,and the interstitial cells are fusiform.With the increased of grading,the cell atypia was greater,and the cells were arranged in the shape of running water,network or focal dense distribution or cell density.There was overlap in morphology,the difference of zoning phenomenon was not statistically significant(P=0.052).The differences of CD34,CD10,CD117 and p53 between JFAs and PTs were statistically significant(P=0.000、P=0.000、P=0.013、P=0.000).The differences of CD34,CD117 and p53 in BPTs,Bo PTs and MPTs were statistically significant(P=0.000,P=0.000,P=0.024),while the differences of CD10 in BPTs,Bo PTs and MPTs were not statistically significant(P=0.314).Conclusion: 1.Zoning phenomenon could not be used as distinguishing points between JFAs and PTs.2.Immunohistochemical markers have a limited role in differentiating JFAs from PTs,and morphological characteristics are still the main diagnostic basis.3.CD34,CD10,CD117 and p53 have certain reference role in differentiating JFAs from PTs.