| Project/Area Number |
16K08654
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Human pathology
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| Research Institution | Saitama Medical University (2018-2019)
National Hospital Organization Nagoya Medical Center (2016-2017) |
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Principal Investigator |
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2016: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
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| Keywords | 乳腺 / 神経内分泌癌 / 神経内分泌腫瘍 / 乳癌 / 特殊型 / 人体病理学 / 臨床細胞学 / 免疫組織化学 / 神経内分泌型非浸潤性乳管癌 / 腺様嚢胞癌 / 神経内分泌細胞過形成 |
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| Outline of Final Research Achievements |
1) Although breast neuroendocrine neoplasm (B-NEN) had been considered to have a favorable prognosis with sensitivity to hormonal treatments and chemotherapy, we demonstrated B-NENs to follow a more aggressive clinical course, even though most immuno-express ER/PgR with negativity for HER2, as compared to invasive mammary carcinomas of no special type.
2) We clarified the clinical significance, biological characteristics and cytopathological features of neuroendocrine ductal carcinoma in situ (NE-DCIS) as a pre-invasive counterpart of B-NENs (Best Poster Award of ICC/International Academy of Cytology, 2019).
3) NE cell hyperplasia, i.e. isolated/scattered, clustered and/or circumferential proliferations of normal-looking NE cells, could appear in the mammary tissues and be associated with the development of B-NENs. This novel observation of NE cells and patterns in non-neoplastic breast epithelia has implications for understanding of B-NEN carcinogenesis as well as for future therapies.
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| Academic Significance and Societal Importance of the Research Achievements |
B-NECは独特な臨床像、画像所見、病理学的特徴を示す浸潤性乳癌の特殊型であり、発生機構および治療法が近年注目されている。本腫瘍は通常型の乳癌と比較し悪性度がしばしば高く、分子標的薬をはじめ新規治療の確立が求められる。組織発生に関し、癌の異分化と一般に考えられているが、神経内分泌形質の獲得は様々な段階で起こり、さらに多発病変のバックグラウンドとなる神経内分泌細胞過形成、良性乳管内増殖性病変との関連性等、複数のメカニズムが関与する。これはB-NECの自然史を解明する上で重要であり、治療法に一石を投じる可能性がある。浸潤前病変であるNE-DCISは、過小診断されやすいという診断学的意義も有する。
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