乳腺实性乳头状癌11例临床病理特征分析

Analysis of Clinicopathological Features of 11 Cases of Solid Papillary Carcinoma of the Breast

摘要: 本研究回顾性分析11例乳腺实性乳头状癌(SPC)患者的临床病理资料。患者均为女性，中位年龄67岁，临床表现以乳房肿块或乳头血性溢液为主。病理诊断包括原位型5例、伴微浸润1例及伴浸润性癌5例。所有病例雌激素受体(ER)、孕激素受体(PR)均呈弥漫强阳性，人表皮生长因子受体2 (HER2)均为阴性，神经内分泌标志物普遍表达。前哨淋巴结活检9例均为阴性，随访期间未见复发转移。研究提示SPC具有特征性免疫表型与惰性临床进程，诊断需综合形态学与免疫组化，准确区分原位与浸润成分对指导个体化治疗、避免过度干预至关重要。

Abstract: This study retrospectively analyzed the clinicopathological data of 11 patients with solid papillary carcinoma (SPC) of the breast. All patients were female with a median age of 67 years. Clinical presentations mainly included breast mass or bloody nipple discharge. Pathological diagnoses comprised 5 cases of in situ SPC, 1 case with microinvasion, and 5 cases with invasive carcinoma. All cases showed diffuse strong positivity for estrogen receptor (ER) and progesterone receptor (PR), were negative for human epidermal growth factor receptor 2 (HER2), and commonly expressed neuroendocrine markers. Sentinel lymph node biopsy was performed in 9 cases, all of which were negative. No recurrence or metastasis was observed during follow-up. The study suggests that SPC exhibits characteristic immunophenotypes and an indolent clinical course. Accurate diagnosis requires integration of histomorphology and immunohistochemistry, and precise distinction between in situ and invasive components is crucial for guiding individualized treatment and avoiding overtreatment.