Papotti M, Gugliotta P, Ghiringhello B, Bussolati G
Histopathology. 1984 Nov;8(6):963-75. doi: 10.1111/j.1365-2559.1984.tb02414.x.
To identify histological preneoplastic lesions and early neoplastic foci, a histological and immunohistochemical study has been conducted on a series of 18 cases with the rare association of multiple intraductal papillomas and in situ breast carcinoma. The pathological and clinical data of these cases have been collated. A close anatomical and spatial association between the benign papillomas and areas of in situ carcinoma (mostly of the cribriform type) was a frequent finding. In agreement with the results of our previous investigations, cytoplasmic CEA has been found to be a marker of intraductal carcinomas, while staining for actin has been found useful to identify the myoepithelial cells present in benign papillomas as opposed to carcinomas. The immunohistochemical procedures for these two markers have been conducted on parallel sections; alternatively, an immunoperoxidase/immuno-galactosidase sequence has been applied on the same section. The results indicate that, in cases with multiple papillomas, CEA-positive, myoepithelial cell-free carcinomatous areas can be anatomically associated with and even present inside the benign-looking papillary lesions. These findings can be interpreted as evidence of a malignant transformation of intraductal papillomas, or, less likely, of their 'cancerization' by ductal carcinoma.
为了识别组织学上的癌前病变和早期肿瘤病灶，我们对18例罕见的多发性导管内乳头状瘤与原位乳腺癌相关病例进行了组织学和免疫组织化学研究。整理了这些病例的病理和临床资料。良性乳头状瘤与原位癌区域（大多为筛状型）之间存在紧密的解剖学和空间关联是常见的发现。与我们之前的研究结果一致，发现细胞质癌胚抗原（CEA）是导管内癌的标志物，而肌动蛋白染色有助于识别良性乳头状瘤中存在的肌上皮细胞，与癌形成对比。这两种标志物的免疫组织化学程序在平行切片上进行；或者，免疫过氧化物酶/免疫半乳糖苷酶序列应用于同一切片。结果表明，在多发性乳头状瘤病例中，CEA阳性、无肌上皮细胞的癌性区域在解剖学上可与看似良性的乳头状病变相关联，甚至出现在其内部。这些发现可解释为导管内乳头状瘤恶性转化的证据，或者可能性较小的是，导管癌对其“致癌作用”的证据。
