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- 请问乳腺小叶癌问题有分级吗
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本帖最后由 于 2009-11-28 23:25:00 编辑
影响浸润性小叶癌预后的最重要因素是肿瘤大小和淋巴结转移, 肿瘤大小与淋巴结转移密切相关.肿瘤小于等于0.5cm, 浸润性小叶癌(ILC)腋窝淋巴结转移率13%; 浸润性导管癌(IDC)12%; 肿瘤小于等于2.0cm, ILC 淋巴结转移率25%;IDC淋巴结转移率27%.
经典型浸润性小叶癌预后比多形性小叶癌和混合型小叶癌好,但小管小叶癌预后比经典型好
有关浸润性小叶癌的分级至今未达共识.如需要可参考 Nottingham 分级系统.
细胞核多形性 nuclear pleomorphism
1分 核略大正常乳腺上皮细胞，外形规则，染色质均匀，核大小一致2分 核大于正常乳腺上皮细胞，核空泡状，有核仁，核大小和形状中度变异
3分 核空泡状，核仁明显，核大小和形状明显变异，可 见巨核和奇异核
核分裂数/10HPF Mitotic counts
1分 4个/10HPF; 2分5-10个/HPF; 3分 ≥11个/10HPF将3项相加后分级(grading) 1级 3-5分; 2级6-7分; 3级8-9分
可运用于浸润性导管癌和浸润性小叶癌.研究者分析表明此分级对浸润性小叶癌预后有统计学意义 参考：Breast Pathology.
Editors O’Malley FP & Pinder SE, 2006 p225-.233
经典型浸润性小叶癌预后比多形性小叶癌和混合型小叶癌好,但小管小叶癌预后比经典型好
有关浸润性小叶癌的分级至今未达共识.如需要可参考 Nottingham 分级系统.
细胞核多形性 nuclear pleomorphism
1分 核略大正常乳腺上皮细胞，外形规则，染色质均匀，核大小一致2分 核大于正常乳腺上皮细胞，核空泡状，有核仁，核大小和形状中度变异
3分 核空泡状，核仁明显，核大小和形状明显变异，可 见巨核和奇异核
核分裂数/10HPF Mitotic counts
1分 4个/10HPF; 2分5-10个/HPF; 3分 ≥11个/10HPF将3项相加后分级(grading) 1级 3-5分; 2级6-7分; 3级8-9分
可运用于浸润性导管癌和浸润性小叶癌.研究者分析表明此分级对浸润性小叶癌预后有统计学意义
- xljin8
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As pointed out above, infiltrating lobular carcinoma is classified as (1) classical type, (2) pleomorphic/histiocytoid type, (3) mixed classic and histiocytoid type, and (4) tubulolobular type. Histiocytoid lobular carcinoma seems to behaves more aggressively than classical lobular carcinoma. These two types (and the mixed type) can be seen in lobular carcinoma in situ as well. In the old days, there was no standardized way to grade infiltrating lobular carcinomas. For more than 10 years now, however, most pathologists have adopted the Nottingham histologic score (the same scoring system used for infiltrating ductal carcinomas) in grading infiltrating lobular carcinomas. Three features (tubular differentiation, nuclear atypia and mitotic activity) are graded as scores 1 to 3, and the combined score of all three features decides the overall tumor grade (from grade 1 to 3).
聞道有先後,術業有專攻
