乳腺包裹性乳头状癌 3 例报道并文献复习_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

甘凤娇 ¹ , 胡康 ¹ , 罗清 ² , 李艳 ¹ ,  孙素红 ¹

1. ;
2. ;

Corresponding author：

孙素红, Email: zyyxy_ssh@sina.com

Keywords：

包裹性乳头状癌; 影像学检查; 临床病理学特征; 免疫组织化学

DOI：

10.7507/1007-9424.201812012

Video：

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目的总结乳腺包裹性乳头状癌（encapsulated papillary carcinoma，EPC）的临床病理学特征、诊断、鉴别诊断以及治疗方法，从而加深对 EPC 疾病的认识以及规范诊治。方法回顾性分析遵义医科大学附属医院 2012 年 1 月至 2018 年 11 月期间收治且经术后石蜡标本病理学检查明确诊断为 EPC 患者的临床资料，并结合相关文献总结其临床病理学特征以及治疗方法。结果共收集到 3 例患者，均为女性，年龄分别为 36 岁、50 岁、70 岁。其中 2 例以“发现乳腺肿块”就诊，肿块均为单发，边界清楚；另 1 例以“乳房胀痛伴乳头溢血溢液 2⁺ 年”入院。2 例患者的免疫表型为 Luminal 型，1 例免疫表型为三阴性型。 2 例 Luminal 型患者以手术治疗为主，而三阴性型以手术治疗及术后化疗为主。3 例患者目前在随访中、无复发及转移。结论乳腺 EPC 是厚的纤维囊壁包裹且囊壁肌上皮缺乏特殊亚型的浸润性癌，预后较好。其中 Luminal 型 EPC 的治疗原则同导管原位癌（ductal carcinoma in situ，DCIS），而三阴性型 EPC 的治疗参照传统型浸润性乳腺癌。

Citation： 甘凤娇, 胡康, 罗清, 李艳, 孙素红. 乳腺包裹性乳头状癌 3 例报道并文献复习. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 343-347. doi: 10.7507/1007-9424.201812012 Copy

1.	Fayanju OM, Ritter J, Gillanders WE, et al. Therapeutic management of intracystic papillary carcinoma of the breast: the roles of radiation and endocrine therapy. Am J Surg, 2007, 194(4): 497-500.
2.	Khoury T, Hu Q, Liu S, et al. Intracystic papillary carcinoma of breast: interrelationship with in situ and invasive carcinoma and a proposal of pathogenesis: array comparative genomic hybridization study of 14 cases. Mod Pathol, 2014, 27(2): 194-203.
3.	Esposito NN, Dabbs DJ, Bhargava R. Are encapsulated papillary carcinomas of the breast in situ or invasive? A basement membrane study of 27 cases. Am J Clin Pathol, 2009, 131(2): 228-242.
4.	Hill CB, Yeh IT. Myoepithelial cell staining patterns of papillary breast lesions: from intraductal papillomas to invasive papillary carcinomas. Am J Clin Pathol, 2005, 123(1): 36-44.
5.	Lakhani SR, Ellis IO, Schnitt SJ, et al. WHO classification of tumors of the breast. 4th ed. Lyon: IARC Press, 2012: 106-107.
6.	George K, Anna Z, Evanthia K, et al. Encapsulated papillary carcinoma of the breast: An overview. J Cancer Res Ther, 2013, 9(4): 564-570.
7.	Rakha EA, Varga Z, Elsheik S, et al. High-grade encapsulated papillary carcinoma of the breast: an under-recognized entity. Histopathology, 2015, 66(5): 740-746.
8.	佟凌霞, 齐娜, 郑鹏远. 乳腺囊实性病变的超声诊断分析. 中国妇幼保健, 2017, 32(5): 1080-1082.
9.	徐树明, 程林仙, 原韶玲, 等. 乳腺囊内乳头状癌的影像学表现与临床病理对照分析. 中国药物与临床, 2013, 13(8): 1039-1041.
10.	甘咏莉, 葛荣, 丁锦华, 等. 乳腺包被性乳头状癌临床病理观察. 实用肿瘤杂志, 2013, 28(5): 506-508.
11.	丁锦华, 吴伟主, 甘咏莉. 乳腺包被性乳头状癌的临床病理特征及预后分析. 中国癌症杂志, 2013, 23(5): 357-361.
12.	苑著, 屈翔, 王宇, 等. 乳腺包裹性乳头状癌的临床特点与病理组织学特征. 临床和实验医学杂志, 2013, 12(21): 1734-1737.
13.	卢晓梅, 柳玮华. 乳腺囊内乳头状癌 4 例临床病理分析. 临床和实验医学杂志, 2012, 11(1): 36-39.
14.	张清泉, 刘洪博, 李聪, 等. 乳腺包裹性乳头状癌 1 例. 广东医学, 2013, 34(11): 1644.
15.	李志峰, 陈建新. 乳腺包膜内乳头状癌伴浸润一例及文献复习. 中华乳腺病杂志(电子版), 2013, 7(4): 309-311.
16.	王维娜, 陈海霞, 张银华, 等. 乳腺包被性乳头状癌的临床病理分析. 肿瘤防治研究, 2015, 42(6): 591-596.
17.	Collins LC, Carlo VP, Hwang H, et al. Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol, 2006, 30(8): 1002-1007.
18.	刘裔莎, 魏兵, 步宏, 等. 乳腺包裹性乳头状癌 17 例临床病理观察. 临床与实验病理学杂志, 2012, 28(7): 726-731.
19.	Kuroda N, Fujishima N, Hayes MM, et al. Encapsulated papillary carcinoma, apocrine type, of the breast. Malays J Pathol, 2014, 36(2): 139-143.
20.	Kővári B, Ormándi K, Simonka Z, et al. Apocrine encapsulated papillary carcinoma of the breast: the first reported case with an infiltrative component. J Breast Cancer, 2018, 21(2): 227-230.
21.	Li X, Xu Y, Ye H, et al. Encapsulated papillary carcinoma of the breast: A clinicopathological study of 49 cases. Curr Probl Cancer, 2018, 42(3): 291-301.
22.	Yee C, Drost L, Niglas M, et al. Early local recurrence in a patient with encapsulated papillary carcinoma of the breast. Clin Breast Cancer, 2018, 18(4): e447-e448.
23.	Rakha EA, Gandhi N, Climent F, et al. Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. Am J Surg Pathol, 2011, 35(8): 1093-1103.

1. Fayanju OM, Ritter J, Gillanders WE, et al. Therapeutic management of intracystic papillary carcinoma of the breast: the roles of radiation and endocrine therapy. Am J Surg, 2007, 194(4): 497-500.
2. Khoury T, Hu Q, Liu S, et al. Intracystic papillary carcinoma of breast: interrelationship with in situ and invasive carcinoma and a proposal of pathogenesis: array comparative genomic hybridization study of 14 cases. Mod Pathol, 2014, 27(2): 194-203.
3. Esposito NN, Dabbs DJ, Bhargava R. Are encapsulated papillary carcinomas of the breast in situ or invasive? A basement membrane study of 27 cases. Am J Clin Pathol, 2009, 131(2): 228-242.
4. Hill CB, Yeh IT. Myoepithelial cell staining patterns of papillary breast lesions: from intraductal papillomas to invasive papillary carcinomas. Am J Clin Pathol, 2005, 123(1): 36-44.
5. Lakhani SR, Ellis IO, Schnitt SJ, et al. WHO classification of tumors of the breast. 4th ed. Lyon: IARC Press, 2012: 106-107.
6. George K, Anna Z, Evanthia K, et al. Encapsulated papillary carcinoma of the breast: An overview. J Cancer Res Ther, 2013, 9(4): 564-570.
7. Rakha EA, Varga Z, Elsheik S, et al. High-grade encapsulated papillary carcinoma of the breast: an under-recognized entity. Histopathology, 2015, 66(5): 740-746.
8. 佟凌霞, 齐娜, 郑鹏远. 乳腺囊实性病变的超声诊断分析. 中国妇幼保健, 2017, 32(5): 1080-1082.
9. 徐树明, 程林仙, 原韶玲, 等. 乳腺囊内乳头状癌的影像学表现与临床病理对照分析. 中国药物与临床, 2013, 13(8): 1039-1041.
10. 甘咏莉, 葛荣, 丁锦华, 等. 乳腺包被性乳头状癌临床病理观察. 实用肿瘤杂志, 2013, 28(5): 506-508.
11. 丁锦华, 吴伟主, 甘咏莉. 乳腺包被性乳头状癌的临床病理特征及预后分析. 中国癌症杂志, 2013, 23(5): 357-361.
12. 苑著, 屈翔, 王宇, 等. 乳腺包裹性乳头状癌的临床特点与病理组织学特征. 临床和实验医学杂志, 2013, 12(21): 1734-1737.
13. 卢晓梅, 柳玮华. 乳腺囊内乳头状癌 4 例临床病理分析. 临床和实验医学杂志, 2012, 11(1): 36-39.
14. 张清泉, 刘洪博, 李聪, 等. 乳腺包裹性乳头状癌 1 例. 广东医学, 2013, 34(11): 1644.
15. 李志峰, 陈建新. 乳腺包膜内乳头状癌伴浸润一例及文献复习. 中华乳腺病杂志(电子版), 2013, 7(4): 309-311.
16. 王维娜, 陈海霞, 张银华, 等. 乳腺包被性乳头状癌的临床病理分析. 肿瘤防治研究, 2015, 42(6): 591-596.
17. Collins LC, Carlo VP, Hwang H, et al. Intracystic papillary carcinomas of the breast: a reevaluation using a panel of myoepithelial cell markers. Am J Surg Pathol, 2006, 30(8): 1002-1007.
18. 刘裔莎, 魏兵, 步宏, 等. 乳腺包裹性乳头状癌 17 例临床病理观察. 临床与实验病理学杂志, 2012, 28(7): 726-731.
19. Kuroda N, Fujishima N, Hayes MM, et al. Encapsulated papillary carcinoma, apocrine type, of the breast. Malays J Pathol, 2014, 36(2): 139-143.
20. Kővári B, Ormándi K, Simonka Z, et al. Apocrine encapsulated papillary carcinoma of the breast: the first reported case with an infiltrative component. J Breast Cancer, 2018, 21(2): 227-230.
21. Li X, Xu Y, Ye H, et al. Encapsulated papillary carcinoma of the breast: A clinicopathological study of 49 cases. Curr Probl Cancer, 2018, 42(3): 291-301.
22. Yee C, Drost L, Niglas M, et al. Early local recurrence in a patient with encapsulated papillary carcinoma of the breast. Clin Breast Cancer, 2018, 18(4): e447-e448.
23. Rakha EA, Gandhi N, Climent F, et al. Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. Am J Surg Pathol, 2011, 35(8): 1093-1103.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

乳腺包裹性乳头状癌 3 例报道并文献复习

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