Department of Pathology, Magee-Women's Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Am J Surg Pathol. 2013 Jul;37(7):e1-11. doi: 10.1097/PAS.0b013e3182918a2b.
Lobular neoplasia (LN) is a term that encompasses both lobular carcinoma in situ and atypical lobular hyperplasia. These lesions have been shown to constitute both risk indicators and nonobligate precursors of invasive breast cancer, they are relatively uncommon, and are most often identified in specimens taken for other reasons. Their incidence has increased in the last 2 decades, and novel variants, including a pleomorphic type, have been described. Loss of E-cadherin expression is recognized as a hallmark diagnostic feature of LN and invasive lobular carcinomas, and immunohistochemical (IHC) analysis using anti-E-cadherin antibodies has been proven to be a useful method to differentiate between lobular and ductal lesions. The frequent use of E-cadherin IHC analysis in routine diagnostic histopathology, however, has resulted in confusion with regard to the actual value of IHC with antibodies against E-cadherin and other proteins of the cadherin-catenin complex. This review provides an update on recent clinicopathologic and molecular data on LN and invasive lobular carcinoma and a discussion about the use and limitations of IHC with E-cadherin in diagnostic breast pathology.
小叶肿瘤性病变（LN）是一个术语，包括原位小叶癌和不典型小叶增生。这些病变已被证明是乳腺癌浸润的风险指标和非必需前体，它们相对较少见，并且最常在因其他原因采集的标本中被发现。在过去的 20 年中，它们的发病率有所增加，并且已经描述了新型变体，包括多形性类型。E-钙黏蛋白表达缺失被认为是 LN 和浸润性小叶癌的标志性诊断特征，使用抗 E-钙黏蛋白抗体的免疫组织化学（IHC）分析已被证明是区分小叶和导管病变的有用方法。然而，E-钙黏蛋白 IHC 分析在常规诊断组织病理学中的频繁使用导致了对 E-钙黏蛋白和钙黏蛋白-连环蛋白复合物的其他蛋白的 IHC 抗体的实际价值存在混淆。这篇综述提供了关于 LN 和浸润性小叶癌的最新临床病理和分子数据的更新，并讨论了在诊断性乳腺病理学中使用和限制 E-钙黏蛋白 IHC 的问题。
