Karim Rooshdiya Z, Scolyer Richard A, Tse Gary M, Tan Puay-Hoon, Putti Thomas C, Lee C Soon
Department of Anatomical Pathology, Royal Prince Alfred Hospital, Sydney, Australia.
Pathology. 2009 Feb;41(2):105-17. doi: 10.1080/00313020802579342.
Mammary phyllodes tumours (PTs) are rare fibroepithelial neoplasms of the breast. They have a propensity to recur locally and the ability to metastasise. There is some correlation between the histological parameters of PTs and their biological behaviour; however, no single feature or grading scheme can accurately predict the behaviour of a PT. The PTs that will recur and/or metastasise are not being precisely delineated with the currently available diagnostic tools. A number of pathways/markers have been implicated in the pathogenesis of PTs including hormone receptors, members of the Wnt pathway, cell cycle proteins, factors involved in angiogenesis, tyrosine kinase receptors and matrix metalloproteases. The currently available evidence supports a model where initiation of PTs involves interactions between the epithelium and stroma and these interactions are lost with the progression to malignancy such that growth of the stroma becomes autonomous of the epithelium. Loss of the stromal-epithelial interdependancy, increased stromal proliferation, angiogenesis and matrix alterations appear to be involved in the progression to malignancy.
乳腺叶状肿瘤（PTs）是一种罕见的乳腺纤维上皮性肿瘤。它们有局部复发的倾向以及转移的能力。PTs的组织学参数与其生物学行为之间存在一定相关性；然而，没有单一特征或分级方案能够准确预测PT的行为。目前可用的诊断工具无法精确界定哪些PTs会复发和/或转移。许多信号通路/标志物与PTs的发病机制有关，包括激素受体、Wnt信号通路成员、细胞周期蛋白、血管生成相关因子、酪氨酸激酶受体和基质金属蛋白酶。目前的证据支持一种模型，即PTs的起始涉及上皮和间质之间的相互作用，而随着肿瘤进展至恶性阶段，这些相互作用丧失，使得间质生长变得独立于上皮。间质 - 上皮相互依赖性的丧失、间质增殖增加、血管生成和基质改变似乎都参与了向恶性肿瘤的进展过程。
