摘要目的 观察基底细胞样乳腺癌的临床病理特征及免疫组织化学表现,探讨其诊断标准.方法 根据免疫表型将448例乳腺癌分为腺腔A型、腺腔B型、正常乳腺样型、HER2过表达型、基底细胞样型进行临床病理分析、形态学观察及免疫组织化学InVitrogen二步法染色.结果 基底细胞样乳腺癌共69例,占15.4％(69/448).形态学特征主要有:由实性巢片状的癌组织构成,呈弥漫性生长方式；癌组织中央出现无细胞性瘢痕区；出现地图样片状坏死区域；癌组织呈推进性生长方式,有推挤性边缘；间质有不同程度的淋巴细胞浸润；肿瘤细胞呈合体状、界限不清；瘤细胞呈泡状核样,常可见明显核仁；核分裂象多见；常伴化生成分(均P＜0.01).基底细胞样乳腺癌高度表达CK5/6、CK14、CK17(均P＜0.01).结论 基底细胞样乳腺癌具有一定的形态学特征和独特的免疫表型特点.

abstractsObjective To investigate the clinicopathologic features and immunohistochemical of the basal-like subtype of invasive breast carcinoma (BLBC),and to discuss the diagnosis standard.Methods Immunohistochemistry was performed in 448 cases of breast carcinoma and these cases were categorized into luminal A,luminal B,null subtypes,HER2-overexpressing and basal-like and their clinicopathologic features were observed under light microscope with stains of HE and immunohistochemical InVitrogen staining.Results Among the breast cancer patients,the incidence of BLBC was 15.4％ (69/448).Morphologic features significantly associated with BLBC constituently included nest structure and showing diffuse growth pattern,large scarring areas without cells in tumor,geographic necrosis,pushing margin of invasion,lymphocytic infiltrate in various degree in tumor stroma,syncytial tumor cell without clear boundaries,tumor cell showing vesicular unclear chromatin and nucleolus,markedly elevated mitotic count,metaplasia (all P ＜ 0.01).Meanwhile,most BLBC showed strong immunoreactivity for CK5/6,CK14,CK17 (all P ＜ 0.01).Conclusion BLBC showed distinct morphologic and immunophenotypic features.