Clinicopathologic features and prognostic factors of malignant phyllodes tumors / 中华病理学杂志
Chinese Journal of Pathology
;
(12): 729-734, 2013.
Article
in Chinese
| WPRIM
| ID: wpr-288222
ABSTRACT
<p><b>OBJECTIVE</b>To study the clinicopathologic features of malignant phyllodes tumors (PT) by histopathologic analyses, immunohistochemical profiling and DNA content assay, and evaluation of the clinical outcome.</p><p><b>METHODS</b>Ten patients with malignant PT from 1999 to 2013 who were treated by surgery were enrolled in this study. The morphologic characteristics were studied under light microscope, standard two-step EnVision method of immunohistochemical staining was used to assess the expression of CK5/6, CKpan, 34β E12, desmin, p63, ER-α, PR, Ki-67, CD34, SMA, p53, p16, bcl-2 and CD117 in the tumors. The corresponding paraffin blocks were also used for flow cytometric DNA content assay. These data were correlated with the follow-up results.</p><p><b>RESULTS</b>The median age of onset was 46.5 years old. The mean tumor size was 7.4 cm (2.0-25.0 cm). At the end of the follow-up period (22 to 125 months), there were tumor recurrences in 3/8 patients and the median time of recurrence was 24 months. Metastasis occurred in 3/8 patients who all died of the tumors. PT had heterogeneous histology, with stromal overgrowth with leaf-like projections, periductal stromal overgrowth, and most commonly, diffuse stromal overgrowth with sarcomatous differentiation. The mean positive index of Ki-67 was 11.4%. The stromal tumor cells were positive for CD34, SMA, p53, p16, and bcl-2 in 3/10, 9/10, 6/10, 8/10, and 4/10 cases, respectively. CD117,ER-α and PR were negative. Interpretable DNA histograms were obtained in nine cases with triploidy in two cases.</p><p><b>CONCLUSIONS</b>The diagnosis of malignant PT should be considered based on the diversity of growth patterns and heterogeneous histology.Ki-67 and CD34 are valuable diagnostic and prognostic factors in patients with malignant PT. Tumors with diffuse stromal overgrowth, heterologous elements, Ki-67 ≥ 20% or aneuploidy are more likely to metastasize.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pathology
/
General Surgery
/
Therapeutics
/
Bone Neoplasms
/
Breast Neoplasms
/
Immunohistochemistry
/
Follow-Up Studies
/
Phyllodes Tumor
/
Antigens, CD34
/
Ki-67 Antigen
Type of study:
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
Language:
Chinese
Journal:
Chinese Journal of Pathology
Year:
2013
Type:
Article
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