Teixeira M R, Qvist H, Bøhler P J, Pandis N, Heim S
Department of Genetics, The Norwegian Radium Hospital and Institute for Cancer Research, Oslo.
Genes Chromosomes Cancer. 1998 Jun;22(2):145-51.
Carcinosarcoma of the breast is a rare biphasic neoplasm composed of a carcinomatous component contiguous or admixed with a pleomorphic spindle cell component. The issues of the histogenesis and clonal composition of carcinosarcomas have long been debated. We present the first cytogenetic characterization of mammary carcinosarcomas by analysis of eight tumor samples from two patients with this disease. In the first case, the same karyotypically complex clone, as well as evidence of clonal evolution, was found in samples from three separate areas of the primary tumor. The analysis of one intramammary and one axillary lymph node metastasis from the same patient, both showing only the sarcomatous tumor component, also revealed the common complex stemline and one of the two sidelines found in the primary tumor. The carcinosarcoma of the second patient contained six complex but karyotypically related clones unevenly distributed among the three samples examined. From this case, cells belonging to the carcinomatous and sarcomatous tumor components were separated by differential sedimentation and culturing in specific growth media. Analysis of both fractions showed largely the same karyotype, although one of the subclones was restricted to the epithelial component. Our findings indicate that the epithelial and mesenchymal components of mammary carcinosarcomas are both part of the neoplastic parenchyma and that they have evolved from a single common stem cell, in agreement with the hypothesis that the tumors are of monoclonal origin.
乳腺癌肉瘤是一种罕见的双相性肿瘤，由癌性成分与多形性梭形细胞成分相邻或混合组成。癌肉瘤的组织发生和克隆组成问题长期以来一直存在争议。我们通过分析两名患有这种疾病的患者的八个肿瘤样本，首次对乳腺癌肉瘤进行了细胞遗传学特征分析。在第一例病例中，在原发肿瘤三个不同区域的样本中发现了相同的核型复杂克隆以及克隆进化的证据。对同一患者的一个乳腺内转移灶和一个腋窝淋巴结转移灶进行分析，这两个转移灶均仅显示肉瘤样肿瘤成分，结果也揭示了在原发肿瘤中发现的共同复杂主干线和两条旁系中的一条。第二名患者的癌肉瘤包含六个复杂但核型相关的克隆，在三个检测样本中分布不均。在这个病例中，通过差异沉降和在特定生长培养基中培养，将属于癌性和肉瘤样肿瘤成分的细胞分离。对两个部分的分析显示核型基本相同，尽管其中一个亚克隆仅限于上皮成分。我们的研究结果表明，乳腺癌肉瘤的上皮和间充质成分都是肿瘤实质的一部分，并且它们从单个共同干细胞进化而来，这与肿瘤是单克隆起源的假设一致。
