浆膜腔积液转移性乳腺癌17例细胞病理学特征及分子分型分析
Cytopathological characteristics and molecular subtyping of 17 cases of metastatic breast cancer with serous effusion
马燕红 1陆夏良 1覃玲艳 2尤志群 2姚义兴 1许恩云 1顾冬梅2
作者信息
- 1. 苏州大学附属苏州九院病理科(江苏省苏州市 215200)
- 2. 苏州大学附属第一医院病理科
- 折叠
摘要
目的:探讨浆膜腔积液转移性乳腺癌的细胞病理学特征、分子分型及临床预后.方法:回顾性分析 2016年 4月至 2023年 9月苏州大学附属苏州九院 2例、苏州大学附属第一医院 15例浆膜腔积液诊断转移性乳腺癌的病例,分析其细胞病理形态学特征、分子分型改变,并进行预后观察.结果:浆膜腔积液转移性乳腺癌细胞病理形态学特征为:1)浸润性导管癌:一种为细胞呈巢团状或彩球样结构,核质比增高,核膜不规则,胞质可见黏液空泡;另一种为细胞呈平铺状,单个散在分布,大小形态不一,细胞核增大,核质比增高;2)浸润性小叶癌:细胞散在分布,大小形态较一致,细胞核形态相对规则,但核质比增高.17例乳腺癌中,有 6例分子分型发生转变,其中 1例从Luminal A型转变成三阴型,1例从Luminal B型转变成HER-2过表达型,4例从Luminal B型转变成三阴型.结论:根据浆膜腔积液的细胞病理形态学特征,结合免疫细胞化学染色和荧光原位杂交染色(FISH)分析,对判断肿瘤细胞组织来源及分子分型具有重要意义,可为临床精准治疗和判断预后提供重要的依据.
Abstract
Objective:To elucidate the cytopathological characteristics,molecular subtypes,and clinical prognoses of metastatic breast car-cinoma with serosal effusions.Methods:Seventeen cases that included effusion cytology and clinical data were retrospectively analyzed.Two patients were diagnosed between April 2016 and September 2023 at the Suzhou Ninth Hospital Affiliated to Soochow University,and 15 patients were diagnosed at The First Affiliated Hospital of Soochow University.Cytopathological characteristics,molecular subtypes,and prognoses were analyzed.Results:The cytopathological features of metastatic breast carcinoma in serosal effusions were as follows:1)In-vasive ductal carcinoma:one cell type was relatively densely arranged in nests or colored spheres,which displayed an elevated nuclear/cyto-plasmic ratio,irregular nuclear membrane,and cytoplasmic mucin vacuoles.The other cell type was tiled,single scattered,and varied in size and shape,with enlarged nuclei and elevated nuclear/cytoplasmic ratio.2)Invasive lobular carcinoma:cells were scattered and uniform in size and shape.The nuclei had a relatively regular shape,but displayed an elevated nuclear-to-cytoplasmic ratio.Among the 17 breast can-cer cases,6 had transitioned in molecular subtyping,including 1 case from Luminal A to triple-negative type,1 case from Luminal B to hu-man epidermal growth factor receptor 2(HER-2)-overexpressing type,and 4 cases from Luminal B to triple-negative type.Conclusions:The cytopathological characteristics of serous effusion cells combined with immunocytochemical staining and fluorescence in situ hybridization(FISH)suggest that it is important to determine the origin and molecular typing of tumor cells.This provides an important basis for precise clinical treatment and prognosis.
关键词
转移性乳腺癌/浆膜腔积液/细胞病理学特征/分子分型Key words
metastatic breast carcinoma/serosal effusion/cytopathological features/molecular subtype引用本文复制引用
出版年
2024
NETL
NSTL
万方数据