Specific morphological features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of breast
Specific morphological features predictive for the basal phenotype in grade 3 invasive ductal carcinoma of breast
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DOI：
10.1111/j.1365-2559.2006.02453.x
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发表时间：
2006-07-01
期刊：
影响因子：
6.4
通讯作者：
Hanby, A.
中科院分区：
文献类型：
--
作者：
Fulford, L. G.;Easton, D. F.;Hanby, A.
目的：细胞角蛋白（CK）14，肌上皮标志物，也表达在一定比例的乳腺癌。有证据表明，这些肿瘤显示出与其他浸润性导管癌（IDC）不同的转移模式和临床结果，可能需要不同的管理。目前，它们在常规实践中未被识别，并且没有形态学指南来帮助它们的识别。本研究的目的是分析CK 14 + IDC.Methods和结果的组织学特征：一个详细的组织学审查453级3 IDCs显示88（19.4%），表达CK 14。由两名病理学家使用标准化的“勾选框”形式，包括等级、结构和细胞学特征，独立进行评估。使用逻辑回归分析结果，以确定预测基础表型的特征。两名病理学家之间的一致性对于大多数参数来说是一般到良好（kappa 0.4-0.6）。在多元逻辑回归分析中，基底表型与中央瘢痕的存在高度显著相关（P = 0.005），肿瘤坏死（P < 0.0001），梭形细胞的存在（P = 0.006）或鳞状上皮化生（P < 0.0001），总有丝分裂计数高（高倍视野> 40/10）（P = 0.0002）和较高的核浆比（P = 0.0002）。结论：基底细胞样乳腺癌与其特殊的形态学特征密切相关。这些可以用于常规诊断实践中，以确定这一重要的肿瘤子集。
Aims: Cytokeratin (CK) 14, a myoepithelial marker, is also expressed in a proportion of breast carcinomas. There is evidence that these tumours show a differing metastatic pattern and clinical outcome from other invasive ductal carcinomas (IDCs) and may need different management. Currently, they are not identified in routine practice and no morphological guidelines exist to aid their identification. The aim of this study was to analyse the histological features of CK14+ IDC.Methods and results: A detailed histological review of 453 grade 3 IDCs revealed 88 (19.4%) that expressed CK14. Assessment was made independently by two pathologists using a standardized 'tick-box' proforma covering grade, architectural and cytological features. The results were analysed using logistic regression to identify features that predicted for basal phenotype. Concordance between the two pathologists was fair to good for most parameters (kappa 0.4-0.6). On multiple logistic regression, the basal phenotype was highly significantly associated with the presence of a central scar (P = 0.005), tumour necrosis (P < 0.0001), presence of spindle cells (P = 0.006) or squamous metaplasia (P < 0.0001), high total mitotic count (> 40 per 10 high-power field) (P = 0.0002) and high nuclear-cytoplasmic ratio (P = 0.0002).Conclusions: Specific morphological features are strongly associated with basal-like breast carcinoma. These could be used in routine diagnostic practice to identify this important subset of tumours.