Department of Pathology and Molecular Medicine, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Virchows Arch. 2022 Oct;481(4):533-543. doi: 10.1007/s00428-022-03391-8. Epub 2022 Aug 10.
Invasive lobular carcinoma (ILC) is characterized by discohesive cells due to irreversible loss of E-cadherin expression and multiple satellites, where individual cell migration is evident without disturbance of the stroma. Neoplastic cells sometimes infiltrate the surrounding vessel in satellites. Here, we aimed to clarify the specific role of perivascular infiltration (PVI) and ameboid migration, characterized by nondisturbance of the background stromal structure, in ILCs. A total of 139 cases with ILC and 122 cases with invasive breast carcinoma of no special type (IBC-NST) were evaluated retrospectively. PVI was significantly more common in ILC than in IBC-NST (50% [70 of 139 cases] vs. 9% [11 of 122 cases], p < 0.001). ILC cases with PVI showed a larger pathological tumour size than clinical tumour size (p < 0.01), a higher frequency of pathological node status pN2-pN3 when limited to clinically node-negative cases (p < 0.01) and lower circularity of tumour morphology on imaging (p < 0.01) than ILC cases without PVI. In the pathological evaluation, the intensity and occupancy of tumour cells expressing phospho-myosin light chain 2, which is a hallmark of ameboid migration, were significantly higher in ILC cases with PVI than in those without PVI at the tumour margins (p < 0.05). ILC with PVI is associated with irregular, poorly defined tumour margins and lymph node metastasis without adenopathy, which is difficult to assess using imaging. PVI may be caused by ameboid migration, as shown by the positive expression of phospho-myosin light chain 2. The presence of PVI may be a predictor for clinically node-negative pN2-pN3 in ILC patients.
浸润性小叶癌（ILC）的特征是由于 E-钙黏蛋白表达的不可逆丧失和多个卫星灶导致细胞离散，其中单个细胞迁移明显，而基质不受干扰。肿瘤细胞有时在卫星灶中浸润周围血管。在这里，我们旨在阐明血管周围浸润（PVI）和阿米巴样迁移的特定作用，其特征为背景基质结构不受干扰。回顾性评估了 139 例 ILC 和 122 例浸润性乳腺癌非特殊型（IBC-NST）病例。ILC 中 PVI 的发生率明显高于 IBC-NST（50%[139 例中的 70 例]与 9%[122 例中的 11 例]，p<0.001）。有 PVI 的 ILC 病例的病理肿瘤大小大于临床肿瘤大小（p<0.01），当仅限于临床淋巴结阴性病例时，病理淋巴结状态 pN2-pN3 的频率更高（p<0.01），肿瘤形态的圆形度更低在影像学上（p<0.01）比没有 PVI 的 ILC 病例。在病理评估中，在肿瘤边缘，表达磷酸肌球蛋白轻链 2 的肿瘤细胞的强度和占有率，在有 PVI 的 ILC 病例中明显高于没有 PVI 的病例（p<0.05），磷酸肌球蛋白轻链 2 是阿米巴样迁移的标志。有 PVI 的 ILC 与不规则、边界不清的肿瘤和无淋巴结病的淋巴结转移有关，这很难通过影像学评估。PVI 可能是由阿米巴样迁移引起的，这从磷酸肌球蛋白轻链 2 的阳性表达可以看出。PVI 的存在可能是 ILC 患者临床淋巴结阴性 pN2-pN3 的预测指标。
