EARLY INVASIVE BREAST CANCER. ANALYSIS OF CLINICOPATHOLOGICAL PARAMETERS CORRELATED WITH EARLY METASTASIS

1）回顾性分析了45例非浸润性导管癌患者的临床资料，这些患者均经空芯针穿刺活检（CNB）标本（16个凿孔）确诊。16例（36%）病例在随后的切除（手术）标本中减缓了浸润性导管癌成分，此外，其中4例有淋巴结转移。因此，CNB可能并不总是检测早期浸润性癌的良好方法。2）为了评估早期转移，进行了弹性纤维的特殊染色以及内皮细胞标志物的免疫组化分析。抗D2 -40或抗podplanin检测的淋巴管浸润可见于浸润性癌的周围。即使在常规H&E染色载玻片上也可以检测到中度至重度淋巴管浸润。静脉侵犯在H&E上不能被发现，另一方面，它只能被弹性纤维染色（即弹性纤维染色）识别。Masson-Goldner手术），静脉浸润与患者生存率相关。3）我们收集了最大浸润直径小于10 mm的浸润性导管癌。收集了近200例淋巴结转移病例，但我们从未遇到过最大直径小于3 mm的淋巴结阳性病例。此外，所有淋巴结阳性和浸润性成分3- 4 mm的病例，其非浸润性癌成分中均出现粉刺坏死和高级别细胞核。4）对浸润性微乳头状癌（IMPCa）进行了cDNA微阵列评估，因为IMPCa可能集中于早期转移。IMIPCa被认为具有细胞粘附基因和/或细胞极性相关基因的异常。5）免疫组化在早期浸润成分检测中的作用可能有限。而基底细胞标志物，尤其是细胞角蛋白5、6、14可用于乳头状病变良恶性的鉴别诊断。

1)We have retrospectively re-evaluated 45 cases of non-invasive ductal carcinomas, which had been diagnosed on core needle biopsy (CNB) specimen (16 gouge). At subsequent resected (operative) specimen, 16 (36%) cases slowed invasive ductal carcinoma components, and in addition, 4 of them had lymph nodes metastases. Thus, that CNB may not always be a good procedure to detect early invasive cancer.2)To evaluate early phase of metastases, special staining for elastic fibers as well as immunohistochemical analysis for endothelial cell markers had been performed. Lymph vessel invasion, detected by anti-D2-40 or anti-podplanin, were seen at the periphery of invasive carcinomas. Moderate to severe lymph vessel invasion could be detected even on routine H&E staining glass slides. Venous invasion could not be detected on H&E, on the other hand, it bad been only recognized by elastic fiber stains (ie. Masson-Goldner's procedure), and venous invasion was correlated well with patient survival.3)We have collected invasive ductal carcinomas with less than 10mm of maximum invasive diameter. About 200 cases had been collected, but we have never experienced the case with node positive, if the maximum diameter is less then 3mm. In addition, all of the cases with node positive and 3-4mm invasive components, had comedonecrosis and high grade nuclei in their noninvasive carcinoma components.4)cDNA microarray evaluation had been performed for invasive micropapillaxy carcinoma (IMPCa), because IMPCa may have a focus on early phase metastasis. IMIPCa had been considered to have the abnormalities for cell adhesion genes and/or genes in relation to cell polarity. Some of the had been comfirmed by additional immunostains.5)For detecting early invasive components more objectively, the usefulness of immunohistochemistry may be limited. However, basal cell markers, especially cytokeratin 5, 6, 14, can be used to making differential diagnosis between benign and malignant papillary lesions.