Sapino A, Papotti M, Righi L, Cassoni P, Chiusa L, Bussolati G
Department of Biomedical Sciences and Human Oncology, University of Turin, Italy.
Ann Oncol. 2001;12 Suppl 2:S115-7. doi: 10.1093/annonc/12.suppl_2.s115.
Neuroendocrine (NE) carcinomas of the breast are defined by the diffuse expression of NE markers. This definition includes lesions with 'pure' NE phenotype as well as 'variants' which may co-express mucinous and/or apocrine phenotype. In the present work, the clinical significance of pure' NE differentiation in breast carcinoma and of its 'variants' will be analyzed.
Forty-three NE breast carcinomas immunocytochemically positive for chromogranins and/or synaptophysin in > or = 50% of cells were graded following the Elston and Ellis grading system for breast carcinomas. The production of mucin and the expressionof the apocrine marker Gross Cystic Disease Fluid Protein-15 (GCDFP-15) were correlated with the grade and the hormonal receptor status. The clinical outcome of patients was also analyzed.
The histological grade highly influenced the clinical evolution of NE breast carcinomas. We confirmed that mucinous differentiation is an important indicator of low biological aggressiveness. Estrogen and progesterone receptor expression was also correlated with a better prognosis. Presence of androgen was correlated with the expression of GCDFP-15 in NE tumors.
The histological grade overcomes the immunophenotype in determining the prognosis of NE differentiated carcinomas of the breast. Co-expression of exocrine products in such tumors is related to hormone dependency.
乳腺神经内分泌（NE）癌由NE标志物的弥漫性表达所定义。该定义包括具有“纯”NE表型的病变以及可能共表达黏液性和/或大汗腺表型的“变异型”。在本研究中，将分析乳腺癌中“纯”NE分化及其“变异型”的临床意义。
对43例免疫细胞化学检测显示嗜铬粒蛋白和/或突触素在≥50%的细胞中呈阳性的乳腺NE癌，按照乳腺癌的Elston和Ellis分级系统进行分级。黏液的产生以及大汗腺标志物大囊性病液蛋白15（GCDFP-15）的表达与分级及激素受体状态相关。还分析了患者的临床结局。
组织学分级对乳腺NE癌的临床进展有高度影响。我们证实黏液性分化是低生物学侵袭性的重要指标。雌激素和孕激素受体表达也与较好的预后相关。雄激素的存在与NE肿瘤中GCDFP-15的表达相关。
在确定乳腺NE分化癌的预后方面，组织学分级比免疫表型更具决定性。此类肿瘤中外分泌产物的共表达与激素依赖性有关。
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