| Background:Breast cancer is one of the most common malignant tumors in women.Its incidence rate is increasing year by year.Surgery is the main treatment,chemotherapy,radiotherapy,endocrine therapy,targeted therapy and other individualized comprehensive treatment strategies continue to mature,making breast cancer obtain ideal curative effect and prognosis,but there are still some patients with recurrence and metastasis.The pathological subtypes of breast cancer can be further divided into different molecular subtypes based on as the expression of estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor2(HER2)and Ki67,including luminal subtype,HER2 overexpression subtype and triple negative subtype.The luminal subtype is defined as ER and/or PR positive.In molecular mechanism,the expression activity of ER can regulate the expression of PR,so the expression of ER and PR is usually consistent.However,cases with inconsistent ER and PR expression do exist in the course of clinical practice,especially those with ER-/PR+.At present,there is a lack of studies on the clinicopathological characteristics of such cases in China.Methods:The clinicopathological data of all breast cancer cases with inconsistent ER and PR expression in our hospital from 2011 to 2016 were collected.Meanwhile,the clinicopathological types,age,Ki-67 and HER2 expression of the two groups were analyzed.Results:Among 7961 cases of breast cancer,815 cases(10.2%)have inconsistent expression of ER and PR,447 cases(5.6%)have ER+/PR-breast cancer and 368 cases(4.6%)have ER-/PR+breast cancer.There are no significant differences in the average age(P=0.713),lymph node metastasis(P=0.155)and HER2 expression(P=0.954)between ER-/PR+and ER+/PR-breast cancer groups,The proliferation rate of Ki67 in ER-/PR+group is higher than that in ER+/PR-group(85.6%vs 73.0%).Invasive ductal carcinoma account for 91.6%and 88.1%of ER-/PR+and ER+/PR-breast cancer respectively(P=0.109).Conclusion:There are still cases with inconsistent ER and PR expression with reducing the influence of objective and subjective factors as much as possible.ER-/PR+breast cancer is more likely to have high Ki67 proliferation rate than ER+/PR-breast cancer,indicating poor prognosis.A case of Epstein Barr virus positive large cell neuroendocrine carcinoma in nasopharynx is reported.A 31 years old male patient presented with numbness on his left face,bloody nasal mucus and intermittent headache for more than 2 months.Microscopically,the tumor cells were arranged in sheet and nest shape,with medium size,clear nucleus and obvious nucleolus.Some cells were round to fusiform,with many mitotic figures,about 12 cells/HPF.Immunohistochemical staining showed that the tumor cells were diffusely positive for synaptophysin,CD56,chromaffin A and other neuroendocrine markers,and cytokeratin(CK)5/6,SOX11,and34βE12,LCA,CK7,p16 and P40 were negative.EBER was positive by molecular in situ hybridization.The patients were treated with radiotherapy and chemotherapy. |
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