Harrison M, Coyne J D, Gorey T, Dervan P A
Department of Pathology, Mater Misericordiae Hospital, University College Dublin, Ireland.
Histopathology. 1996 May;28(5):445-50. doi: 10.1046/j.1365-2559.1996.322365.x.
Many classification schemes have been proposed for ductal carcinoma in situ. Architectural heterogeneity is widely recognized. Cytonuclear grade appears to have greater prognostic significance than architectural pattern. This study assesses heterogeneity using a classification based on cytological grade and compares this to architectural heterogeneity in mammographically detected ductal carcinoma in situ. One hundred and twelve cases were classified according to architectural subtypes and the carcinoma nuclei were graded. Necrosis and microcalcification were assessed. Eighty-four percent of ductal carcinomas in situ had a single nuclear grade, whereas only 39% showed a single architectural pattern. High grade nuclei were present in 87% of cases. Necrosis was associated with high nuclear grade. In contrast to architectural heterogeneity, this study shows little ductal carcinoma in situ heterogeneity when classification is based on nuclear grade. Thus, a cytomorphological classification should have the advantage of consistency and reproducibility in comparison to architecture-based classification systems.
针对导管原位癌，已经提出了许多分类方案。结构异质性已得到广泛认可。细胞核分级似乎比结构模式具有更大的预后意义。本研究使用基于细胞学分级的分类方法评估异质性，并将其与乳腺钼靶检测到的导管原位癌的结构异质性进行比较。112例病例根据结构亚型进行分类，并对癌细胞核进行分级。评估坏死和微钙化情况。84%的导管原位癌具有单一的细胞核分级，而只有39%表现出单一的结构模式。87%的病例存在高级别细胞核。坏死与高细胞核分级相关。与结构异质性相反，本研究表明，当基于细胞核分级进行分类时，导管原位癌的异质性较小。因此，与基于结构的分类系统相比，细胞形态学分类应具有一致性和可重复性的优势。
