Moatamed Neda A, Wu Annie, Sarah Khaled, Apple Sophia K
Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
J Clin Pathol. 2015 Jun;68(6):484-7. doi: 10.1136/jclinpath-2014-202729. Epub 2015 Feb 20.
Cytokeratin 7 (CK 7) negative breast tumours are reported to occur rarely. We studied 14 CK 7 negative cases of primary invasive ductal carcinoma (IDC) detected during sentinel lymph node metastases work-up and immunohistochemistry panel in the work-up of metastatic carcinoma of unknown origin. Axillary lymph node metastases were present in seven patients (50%). Oestrogen receptor (ER) was strongly positive in all cases: progesterone receptor in 78%, Her-2/neu in 7% and high proliferation index with Ki-67 >20% was seen in 71% of the cases. Metastatic and/or recurrence were found in 8 of 14 patients (57%) with the mean clinical follow-up of 55 months. Metastatic sites include multiple bones, brain, spinal cord, liver, pancreas, ovary, lung, lymph node other than ipsilateral axillary and skin. 12 of 14 patients received adjuvant chemotherapy. All 14 patients received hormonal therapy and radiation therapy. Morphologically, IDC with neuroendocrine features was noted in 57%. Synaptophysin stain was positive in 57% and chromogranin was positive in 21% of the cases. In conclusion, these CK 7 negative breast carcinomas were ER positive, mostly Her-2/neu negative, had high Ki-67 and frequently showed neuroendocrine differentiation. More than half of these cases had a poor outcome.
据报道，细胞角蛋白7（CK 7）阴性的乳腺肿瘤很少见。我们研究了14例在哨位淋巴结转移检查及不明原发灶转移癌免疫组化检查过程中发现的原发性浸润性导管癌（IDC）CK 7阴性病例。7例患者（50%）存在腋窝淋巴结转移。所有病例雌激素受体（ER）均呈强阳性：孕激素受体阳性率为78%，Her-2/neu阳性率为7%，71%的病例Ki-67>20%显示高增殖指数。14例患者中有8例（57%）出现转移和/或复发，平均临床随访时间为55个月。转移部位包括多骨、脑、脊髓、肝、胰、卵巢、肺、同侧腋窝以外的淋巴结及皮肤。14例患者中有12例接受了辅助化疗。所有14例患者均接受了激素治疗和放疗。形态学上，57%的病例表现为具有神经内分泌特征的IDC。57%的病例突触素染色阳性，21%的病例嗜铬粒蛋白阳性。总之，这些CK 7阴性乳腺癌ER阳性，大多Her-2/neu阴性，Ki-67高，且常显示神经内分泌分化。超过半数的病例预后不良。
