Centrally necrotizing carcinoma of the breast: clinicopathological analysis of 33 cases indicating its basal-like phenotype and poor prognosis
Centrally necrotizing carcinoma of the breast: clinicopathological analysis of 33 cases indicating its basal-like phenotype and poor prognosis
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DOI：
10.1111/j.1365-2559.2010.03616.x
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发表时间：
2010-08-01
期刊：
影响因子：
6.4
通讯作者：
Fu, Earl
中科院分区：
文献类型：
--
作者：
Chang, Yun-Ching;Nieh, Shin;Fu, Earl
目的：探讨乳腺中心性坏死癌的临床病理特点及免疫表型，探讨其与基底样表型及预后的关系。方法：回顾分析33例乳腺中心性坏死癌的临床病理特征及免疫表型特点。对雌激素受体、孕激素受体、HER2、细胞角蛋白(CK)8/18、高分子量CK(34βE12)、CK5/6、CK14、CK17、平滑肌抗原、p63、波形蛋白和表皮生长因子受体进行免疫组织化学研究。Cnc的显著特征是中心的、坏死的或无细胞的区域，周围环绕着可存活的肿瘤细胞的环形区域。中央区表现为三种形态：凝固性坏死型(21例)、纤维化及瘢痕型(9例)和梗死型(3例)。肿瘤细胞为高级别浸润性导管癌。基底细胞样标记物的表达高于肌上皮细胞标记物(87.9%对46.2%)。基底细胞样亚型占63.6%。在基底细胞样标记物中，CK5/6的表达率最高(90.5%)。获得19例患者的随访资料。中位无进展生存期为15.5个月。12例(63.2%)发生局部复发和/或远处转移(中位复发和/或转移时间14.0个月)。结论：鼻咽癌具有明显的形态特征，多表现为基底细胞样免疫表型，预后不良。Cnc是基底细胞样乳腺癌的典型代表。
Centrally necrotizing carcinoma of the breast: clinicopathological analysis of 33 cases indicating its basal-like phenotype and poor prognosisAims:To investigate the clinicopathological features and immunophenotype of centrally necrotizing carcinoma (CNC) of the breast to ascertain its relationship to basal-like phenotype and its prognosis.Methods and results:The clinical and pathological characteristics of 33 CNCs were reviewed. Immunohis-tochemical study of oestrogen receptor, progesterone receptor, HER2, cytokeratin (CK) 8/18, high-molecular-weight CK (34 beta E12), CK5/6, CK14, CK17, smooth muscle antigen, p63, vimentin and epidermal growth factor receptor was performed. The striking feature of CNC was a central, necrotic or acellular zone surrounded by a ring-like area of viable tumour cells. The central zone showed three morphological types: predominance of coagulative necrosis (21 cases), predominance of fibrosis and scar tissue (nine cases) and infarction (three cases). Tumour cells displayed invasive ductal carcinoma of high grade. The expression rate of basal-like markers was higher than that of myoepithelial markers (87.9% versus 46.2%). Basal-like subtype was shown by 63.6% of cases. The expression rate of CK5/6 (90.5%) was highest among basal-like markers. Follow-up data of 19 patients were available. Median progression-free survival was 15.5 months. In 12 patients (63.2%), local recurrence and/or distant metastasis developed (median time to recurrence and/or metastasis, 14.0 months).Conclusions:CNC has distinctive morphological features, which mostly exhibit a basal-like immunophenotype and poor prognosis. CNC is a typical representative of basal-like breast cancer.