侵襲性がんへの高度化率は,コア・ニードル・バイオスピーにおける乳がんのサブ分類を不必要とする
Di Ai1, Abdulwahab M Ewaz2, Kevin Van Smaalen3
1Division of Pathology and Laboratory Medicine, MD Anderson Cancer Center, Houston, TX, USA.
Journal of clinical pathology
|September 4, 2025
まとめ
コア・ニードル・バイオプシー (CNB) のパピラ癌は,切除時に侵襲的な癌に進行する割合が高い. これらの腫瘍をCNBに分類することは,臨床的に有意ではない.
科学分野:
- 病理学について
- 腫瘍学
- 手術腫瘍学
背景:
- 乳房の病変の診断には,コア・ニードル・バイオプシー (CNB) が不可欠です.
- CNBのパピラー病変は,決定的な侵入がないため,診断上の課題が生じます.
- CNBの正確な診断は,治療決定と患者のアウトカムに影響します.
研究 の 目的:
- CNBで診断された papillary carcinomaの進行率を評価する.
- CNBにおける papillary carcinomaのサブ分類の臨床的意義を評価する.
- CNBにおけるこれらの病変の総称として"毛細血管がん"の使用を支持する.
主な方法:
- 非侵襲性乳腺がんのCNB症例41件を遡って検討した.
- CNBからのH&Eと免疫ヒストケミストリーのスライドのレビュー.
- 後の切除生検診断の回収と分析
主要な成果:
- 切除後に侵襲性がんに進行する全体の割合は39% (16/41) であった.
- サブタイプは,固体パピラ癌 (83. 3%),封じ込め型パピラ癌 (100%) と異なる進行率を示した.
- 追跡調査中にリンパ節転移,再発,または乳がん関連死亡率は観察されなかった.
結論:
- CNBにおける papillary carcinomaのサブ分類は,高度な増殖率のため,臨床的意義は限られている.
- CNB診断の総称として"乳頭癌"という用語が推奨されている.
- これらの症例のリンパ節除去に関するさらなる調査が必要である.
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