Department of Pathology, Graduate School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Histol Histopathol. 2011 Jan;26(1):79-86. doi: 10.14670/HH-26.79.
An examination was performed on 16 intraductal proliferative breast lesions diagnosed as intraductal papillomas (IP) or usual ductal hyperplasia (UDH), which were followed up for more than 3 years. An immunohistochemical marker panel combining myoepithelial markers, high-molecular-weight keratin (HMWK) and neuroendocrine markers was used. Two of 11 IP cases were re-evaluated as atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS). These cases developed breast cancer after the first operation. One IP case showed repeated recurrences. None of the other IP and UDH cases had breast cancer or recurrence. The ADH, DCIS and the recurrent IP showing a solid growth lacked myoepithelia, but the recurrent IP expressed HMWK, immunohistochemically. Interestingly, these three lesions were weakly positive for neuroendocrine markers. All other IPs and UDHs, including lesions having solid components, were negative for neuroendocrine markers, and most of them were positive for myoepithelial markers and/or HMWK. A combination of the above immunohistochemical markers seems useful to evaluate intraductal proliferative lesions and to predict their prognosis. In particular, intraductal proliferative lesions with solid components exhibiting positivity for neuroendocrine markers should be followed up carefully to monitor breast cancer risk or recurrence.
对 16 例经诊断为导管内乳头状瘤（IP）或普通导管增生（UDH）的导管内增生性乳腺病变进行了检查，这些病变的随访时间超过 3 年。使用了一种结合了肌上皮标志物、高分子量角蛋白（HMWK）和神经内分泌标志物的免疫组织化学标志物组合。11 例 IP 中有 2 例被重新评估为非典型导管增生（ADH）和导管原位癌（DCIS）。这些病例在第一次手术后发展为乳腺癌。1 例 IP 表现为反复复发。其他 IP 和 UDH 均无乳腺癌或复发。显示实性生长的 ADH、DCIS 和复发性 IP 缺乏肌上皮，但复发性 IP 在免疫组织化学上表达 HMWK。有趣的是，这三个病变对神经内分泌标志物呈弱阳性。所有其他的 IP 和 UDH，包括具有实性成分的病变，对神经内分泌标志物均为阴性，其中大多数对肌上皮标志物和/或 HMWK 呈阳性。上述免疫组织化学标志物的组合似乎可用于评估导管内增生性病变并预测其预后。特别是，具有神经内分泌标志物阳性的实性成分的导管内增生性病变应密切随访，以监测乳腺癌风险或复发。
