乳腺浸润性微乳头状癌临床病理特征及预后分析

发布时间：2018-03-02 18:36

本文选题：乳腺癌　切入点：浸润性微乳头状癌　出处：《中华肿瘤防治杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)是一种特殊类型的乳腺浸润性癌,易发生淋巴管、血管侵犯,但对其预后的认识仍存在分歧。本研究拟探讨IMPC的临床病理特征及预后相关性,为临床治疗提供指导。方法采用回顾性分析的方法,形态学观察并评估2006-06-19-2015-10-28国家癌症中心中国医学科学院肿瘤医院病理确诊的89例乳腺IMPC中微乳头状结构的比例,应用免疫组化方法检测ER、PR、HER2及Ki-67的表达,并对各临床病理因素进行生存分析。结果肿瘤内微乳头状癌比例50%组ER阳性率为85.7%,高于微乳头状癌比例25%~50%组(57.1%)和25%组(40%),P=0.013;单纯性IMPC组伴脉管瘤栓比率为58.8%,高于混合性IMPC组的32.4%,P=0.018。随访资料显示,微乳头状癌比例50%组复发/转移率为9.1%,低于微乳头状癌比例25%~50%组(28.6%)和25%组(40.0%),P=0.047。Kaplan-Meier单因素生存分析显示,微乳头状癌成分50%组无瘤生存期长于微乳头状癌成分25%~50%组与25%组,χ~2=4.296,P=0.038;ER阳性组无瘤生存期长于ER阴性组,χ~2=5.324,P=0.021;原发肿瘤T1组无瘤生存期长于T2组,χ~2=7.302,P=0.026。Cox多因素生存分析未发现,影响乳腺IMPC无瘤生存时间的独立预后因素。结论乳腺IMPC虽然易于发生脉管侵犯,但其侵袭性、转移能力及恶性度并不因而增高;原发肿瘤大小、ER状态、微乳头癌比例可能与其预后相关,但有待扩大样本及更长期随访数据的支持。
[Abstract]:Objective invasive micropapillary carcinoma of the breast is a special type of invasive breast carcinoma, which is prone to lymphatic and vascular invasion, but there are still differences in its prognosis. This study was to explore the clinicopathological features and prognostic correlation of IMPC. Methods the proportion of micropapillary structure in 89 cases of breast IMPC confirmed pathologically by the National Cancer Center of China Academy of Medical Sciences was observed and evaluated by retrospective analysis. Immunohistochemical method was used to detect the expression of ER2 and Ki-67. Results the ER positive rate of 50% group with micropapillary carcinoma was 85.7%, which was higher than that of 2550% of micropapillary carcinoma group (57.1%) and 25% group (407.01%), and that of simple IMPC group was 58.8%, which was higher than that of mixed tumor group. In the IMPC group, 32.4% of the patients were in the same group, and the follow-up data showed that, The recurrence / metastasis rate of micropapillary carcinoma group in 50% group was 9.1, which was lower than that in 25% micropapillary carcinoma group (28.6% group) and 25% group (40.0%) group (P < 0.047. Kaplan-Meier survival analysis showed that the rate of micropapillary carcinoma was 0.047. Kaplan-Meier survival analysis. The tumor-free survival time of 50% group with micropapillary carcinoma was longer than that of 25% and 25% groups of micropapillary carcinoma. The tumor-free survival of ER positive group was longer than that of ER negative group, and the tumor-free survival time of T1 group was longer than that of T2 group, and the multivariate survival analysis of 蠂 ~ 2 7.302P ~ (0.026) Cox was not found. Conclusion although breast IMPC is prone to vascular invasion, its invasiveness, metastasis and malignancy are not increased. The percentage of micropapillary carcinomas may be associated with prognosis, but it needs to be supported by expanded samples and longer-term follow-up data.
【作者单位】：国家癌症中心·中国医学科学院北京协和医学院肿瘤医院乳腺外科;国家癌症中心·中国医学科学院北京协和医学院肿瘤医院病理科;
【分类号】：R737.9

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