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乳腺富脂性癌 17 例临床病理分析。

Lipid-rich carcinoma of the breast clinicopathologic analysis of 17 cases.

机构信息

Department of Pathology, School of Medicine Nanjing University/Nanjing Jinling Hospital, Nanjing, P.R. China.

出版信息

Ann Diagn Pathol. 2011 Aug;15(4):225-32. doi: 10.1016/j.anndiagpath.2010.10.006. Epub 2011 Mar 10.

Abstract

Lipid-rich carcinoma of the breast is a rare variant of breast cancer, accounted for <1% of all breast malignant tumors. We retrospectively analyzed the clinicopathologic characteristics of lipid-rich carcinomas of the breast. A panel of estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 (HER-2), cytokeratin (CK) 5/6, CK14, and P63 was prepared for detection of lipid-rich carcinoma. Fluorescence in situ hybridization and electron microscope assays were performed for detecting HER-2 gene amplification and ultrastructure. Survival analysis were carried out using Kaplan-Meier and Cox regression methods. Receiver operating characteristic test was also performed. Estrogen receptor, CK5/6, CK14, and P63 were negative. Progesterone receptor (1/17) and HER-2 (17/17) were positive. HER-2 gene amplification was detected in all included cases (ratio values >2.2). Ultrastructure showed fat droplet and electron-dense material in the cytoplasm. Statistical differences were detected among survival and age (P = .033), histologic grade (P = .004), lymph node involvement (P = .001), and HER-2 expression (P = .002), respectively, using Kaplan-Meier methods. Statistical differences were also detected (P = .017) using Cox regression methods. Receiver operating characteristic test displayed significant statistical differences; the prognosis had a correlation between HER-2 expression "+" and HER-2 expression "++" (P = .004). Lipid-rich carcinoma of the breast was an HER-2 overexpressing subtype of the breast carcinoma. Survival of lipid-rich carcinoma might be associated with age, histologic grade, lymph node involvement, and HER-2. The HER-2 expression, however, might play an important role in predicting the prognosis of lipid-rich carcinoma of the breast.

摘要

乳腺富脂癌是一种罕见的乳腺癌变体,占所有乳腺恶性肿瘤的<1%。我们回顾性分析了乳腺富脂癌的临床病理特征。准备了一组雌激素受体、孕激素受体、人表皮生长因子受体-2(HER-2)、细胞角蛋白(CK)5/6、CK14 和 P63,用于检测富脂癌。进行荧光原位杂交和电子显微镜检测以检测 HER-2 基因扩增和超微结构。使用 Kaplan-Meier 和 Cox 回归方法进行生存分析。还进行了Receiver operating characteristic 测试。雌激素受体、CK5/6、CK14 和 P63 均为阴性。孕激素受体(1/17)和 HER-2(17/17)阳性。所有纳入病例均检测到 HER-2 基因扩增(比值>2.2)。超微结构显示细胞质中有脂肪滴和电子致密物质。Kaplan-Meier 方法显示,生存与年龄(P =.033)、组织学分级(P =.004)、淋巴结受累(P =.001)和 HER-2 表达(P =.002)之间存在统计学差异。Cox 回归方法也显示出统计学差异(P =.017)。Receiver operating characteristic 测试显示出显著的统计学差异;HER-2 表达“+”和“++”之间的预后存在相关性(P =.004)。乳腺富脂癌是一种 HER-2 过表达型乳腺癌。乳腺富脂癌的生存可能与年龄、组织学分级、淋巴结受累和 HER-2 有关。然而,HER-2 表达可能在预测乳腺富脂癌的预后中起重要作用。

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