Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Ngan Shing Street, Shatin, NT, Hong Kong SAR.
Mod Pathol. 2021 Jun;34(6):1062-1073. doi: 10.1038/s41379-021-00736-7. Epub 2021 Feb 2.
Breast cancers with neuroendocrine (NE) differentiation are very heterogeneous, comprising broadly cancers that are morphologically similar to NE tumors (NET) of other anatomic sites, infiltrating breast carcinomas, no special type (IBC-NST) and other special subtypes with NE morphology and/or NE markers expression. Depending on the classification schemes, they are variably included into "NE breast cancers". The latest WHO classification harmonized NE breast cancers with NE neoplasms (NEN) of other organ systems, defined NEN into well-differentiated NET (low Nottingham grade) and poorly-differentiated NE carcinoma (NEC) (high Nottingham grade). Other IBC with NE differentiation are diagnosed based on solely the non-NEN component. Due to the changes in diagnostic criteria, variable results were obtained in the previous studies on NE breast cancers. Hence, the clinical value of NE differentiation in breast cancers is not well investigated and understood. In this review, the current understanding in the pathogenesis, clinical, prognostic, immunhistochemical, and molecular features of "NE breast cancers" is summarized. Controversial issues in their diagnosis and classification are also discussed.
具有神经内分泌 (NE) 分化的乳腺癌具有很大的异质性，包括形态上类似于其他解剖部位的 NE 肿瘤 (NET) 的肿瘤、浸润性乳腺癌、非特殊类型 (IBC-NST) 和其他具有 NE 形态和/或 NE 标志物表达的特殊亚型。根据分类方案的不同，它们被不同程度地归入“NE 乳腺癌”。最新的 WHO 分类将 NE 乳腺癌与其他器官系统的 NE 肿瘤 (NEN) 协调一致，将 NEN 定义为分化良好的 NET（低诺丁汉分级）和分化差的 NE 癌（NEC）（高诺丁汉分级）。其他具有 NE 分化的 IBC 仅基于非 NEN 成分进行诊断。由于诊断标准的变化，之前关于 NE 乳腺癌的研究结果存在差异。因此，NE 分化在乳腺癌中的临床价值尚未得到充分研究和理解。本文总结了“NE 乳腺癌”在发病机制、临床、预后、免疫组织化学和分子特征方面的最新认识。还讨论了它们诊断和分类中的一些有争议的问题。
