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目的探讨乳腺神经内分泌癌的临床诊断与治疗方法。方法回顾性分析2009年1月-2012年5月收治的6例乳腺神经内分泌癌的临床特征、治疗和预后。结果 6例神经内分泌癌均以无痛性肿物就诊,超声提示低回声,边界不清,形态不规则,钼靶提示高密度肿块。病理检查具有神经内分泌癌的形态学特点,6例均表达CgA、Syn、NSE、E-cad,5例ER和PR阳性,6例均不表达Her-2,Ki 67阳性率5%~30%。随访时间10~38个月,无淋巴结转移2例,至今无病存活。4例淋巴结转移,1例内分泌治疗25个月时多发骨转移,至今带瘤存活,3例术后无病存活至今。结论乳腺神经内分泌癌比较罕见。超声提示低回声,边界不清,形态不规则,钼靶提示高密度结节,免疫组织化学染色ER/PR(+)可能是该病的临床特征。组织学特征和免疫组化染色是诊断该病的可靠依据。该病预后与一般乳腺癌无明显差异,与雌孕激素受体状态无关。
Objective To investigate the clinical diagnosis and treatment of breast neuroendocrine carcinoma. Methods The clinical features, treatment and prognosis of 6 cases of breast neuroendocrine carcinoma from January 2009 to May 2012 were retrospectively analyzed. Results All 6 cases of neuroendocrine carcinoma were treated with painless tumor. Ultrasound showed hypoechoic, unclear boundary and irregular shape. Molybdenum target suggested high density mass. Pathological examination showed morphological features of neuroendocrine carcinoma. CgA, Syn, NSE and E-cad were all expressed in 6 cases, ER and PR were positive in 5 cases and Her-2 in 6 cases. The positive rate of Ki 67 was 5% -30% . Follow-up time of 10 to 38 months, no lymph node metastasis in 2 cases, so far disease-free survival. 4 cases of lymph node metastasis, 1 case of endocrine therapy 25 months of multiple bone metastases, so far with tumor survival, 3 cases of disease-free survival to date. Conclusion Breast neuroendocrine cancer is relatively rare. Ultrasound prompt hypoechoic, unclear boundaries, irregular shape, high-density nodules prompted molybdenum target, immunohistochemistry staining ER / PR (+) may be the clinical features of the disease. Histological features and immunohistochemical staining is a reliable basis for the diagnosis of the disease. The prognosis of the disease and no significant difference in general breast cancer, and estrogen and progesterone receptor status has nothing to do.