Abstract：
The exact relationship between solid papillary carcinoma (SPC) and invasive breast carcinoma of no special type (IBC-NST) with neuroendocrine differentiation and SPC and mucinous carcinoma (MC) of the breast remains unclear. To clarify the relationship, we conducted a comparative study of morphological and neuroendocrine features between ductal carcinoma in situ (DCIS, 72 cases) and SPC in situ (35 cases), and IBC-NST (103 cases) and invasive SPC (92 cases). We also conducted the study between MC associated with and without SPC. Synaptophysin, chromogranin A, and INSM1 were employed for the immunohistochemical study. IBC-NST had occasionally a morphological similarity with invasive SPC. While 123 of 127 cases with SPC demonstrated diffuse staining with one or more of the neuroendocrine markers, the only one case of DCIS and none of IBC-NST showed it. Type B was observed in 16 of 18 cases of MC associated with SPC and in 13 of 33 cases of MC without it. All the cases of MC with SPC and 6 of 33 cases without it showed diffuse staining for at least one of the neuroendocrine markers. In conclusion, a careful distinction between invasive SPC and IBC-NST with neuroendocrine differentiation is required. We assume that SPC in situ is a potential candidate for precursor of IBC-NST with neuroendocrine differentiation. MC of the breast is suggested to have two pathogenetic pathways through SPC in situ or non-SPC in situ. SPC in situ is thought to be less common as a precursor of MC than non-SPC in situ.
摘要：
实性乳头状癌（SPC）与非特殊类型浸润性乳腺癌（IBC-NST）与神经内分泌分化以及SPC和乳腺粘液性癌（MC）之间的确切关系尚不清楚。为了澄清这种关系，我们对导管原位癌（DCIS，72例）和SPC原位（35例），IBC-NST(103例)和侵入性SPC(92例)。我们还进行了MC与SPC相关和不相关的研究。突触素，嗜铬粒蛋白A,和INSM1用于免疫组织化学研究。IBC-NST偶尔与侵袭性SPC具有形态学相似性。虽然127例SPC患者中有123例表现出一种或多种神经内分泌标志物的弥漫性染色，唯一的一例DCIS，没有IBC-NST显示。与SPC相关的MC18例中有16例，无SPC的MC33例中有13例。所有带有SPC的MC和33例无SPC的MC中的6例显示至少一种神经内分泌标志物的弥漫性染色。总之,需要仔细区分具有神经内分泌分化的侵袭性SPC和IBC-NST.我们假设原位SPC是具有神经内分泌分化的IBC-NST前体的潜在候选者。建议乳房的MC通过原位SPC或非原位SPC具有两种致病途径。原位SPC被认为比非原位SPC更不常见作为MC的前体。
