The reversed apical pattern of MUC1 expression is characteristics of invasive micropapillary carcinoma of the breast.
The reversed apical pattern of MUC1 expression is characteristics of invasive micropapillary carcinoma of the breast.
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DOI：
10.2325/jbcs.13.58
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发表时间：
2006-01-01
期刊：
影响因子：
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通讯作者：
Inai, Kouki
中科院分区：
文献类型：
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作者：
Li, Yu-sang;Kaneko, Mayumi;Inai, Kouki
背景：乳腺浸润性微乳头状癌(IMPC)是浸润性导管癌(IDC)的一种特殊亚型，具有较高的腋窝淋巴结转移潜能。然而，由于伪影(伪IMPC)，有时很难区分IMPC与显示类似IMPC模式的传统IDC。在本研究中，我们探讨了免疫组织化学MUC1的表达在鉴别IMPC和假性IMPC中的作用，并对IMPC和假性IMPC的几个临床病理参数进行了分析。结果：根据MUC1的表达模式，将80例患者分为单纯IMPC 9例(0.7%)，混合型IMPC 31例(2.5%)，假性IMPC 40例。在单纯IMPC中，MUC1表达位于肿瘤细胞簇的顶膜反面，而在假性IMPC中，MUC1表达于整个细胞膜和/或胞浆。三组患者年龄、肿瘤大小、肿瘤细胞核分级差异无统计学意义。单纯IMPC组和混合IMPC组的淋巴侵袭和淋巴结转移率均高于假性IMPC组，差异有统计学意义。与假性IMPC相比，单纯IMPC复发率高，总生存率低[P=0.0165(DFS)P=0.025(OS)]。单纯IMPC患者的淋巴侵犯和淋巴结转移发生率较高，预后较差。
BACKGROUND: Invasive micropapillary carcinoma (IMPC) of the breast is a special subtype of invasive ductal carcinoma (IDC), which is known to have a high potential to metastasize to the axillary lymph node. However, it is sometimes difficult to differentiate IMPC from conventional IDC showing an IMPC-like pattern due to artifact (pseudo-IMPC). In the present study, we investigated the usefulness of immunohistochemical expression of MUC1 for distinguishing IMPC from pseudo-IMPC, and analyzed several clinicopathological parameters of IMPC and pseudo-IMPC cases.METHODS: Eighty cases showing IMPC or IMPC-like pattern were selected from our surgical files of 1,240 cases of IDC. We examined the expression of MUC1, D2-40 and CD34 by immunohistochemistry.RESULTS: Eighty cases were classified into 9 cases (0.7%) of pure-IMPC, 31 cases (2.5%) of mixed-IMPC, and 40 cases of pseudo-IMPC, according to the expression pattern of MUC1. In pure-IMPC cases, MUC1 expression was found at the reversed apical membrane of neoplastic cell clusters, while in pseudo-IMPC, MUC1 expression was present in the whole cytoplasmic membrane and/or cytoplasm. There were no significant differences among the three groups in patient age, tumor size and nuclear grade of neoplastic cells. However, lymphatic invasion and lymph node metastasis in the pure-IMPC or mixed-IMPC cases were higher than those in pseudo-IMPC cases with statistically significant values. Pure-IMPC has a higher recurrence rate and lower overall survival compared to pseudo-IMPC [P = 0.0165(DFS) P = 0.025(OS)].CONCLUSIONS: This study demonstrated that immunohistochemistry of MUC1 is useful for the diagnosis of IMPC. The pure-IMPC cases had higher incidences of lymphatic invasion and lymph node metastasis, and also showed a poorer prognosis.