晚期乳腺浸润性小叶癌与浸润性导管癌临床病理特征及预后比较

发布时间：2018-04-21 12:18

本文选题：乳腺肿瘤 + 浸润性小叶癌　；参考：《肿瘤》2017年11期

【摘要】：目的 :比较晚期乳腺浸润性小叶癌(invasive lobular carcinoma,ILC)与乳腺浸润性导管癌(invasive ductal carcinoma,IDC)患者的临床病理特征及预后因素。方法:采用回顾性病例对照研究方法,选择2008年1月—2016年12月天津医科大学肿瘤医院收治的59例女性晚期乳腺ILC病例,另按照匹配条件确诊年龄和手术时间(±2年),按1∶4的比例选取同期住院的236例女性晚期乳腺IDC病例。比较2组临床病理特征和预后的差异以及预后相关因素。结果:晚期乳腺ILC患者与IDC患者初诊时的肿瘤临床分期、T分期、M分期、组织学分级、雌激素受体状态、孕激素受体状态、人表皮生长因子受体2状态和分子分型的差异均有统计学意义(P值均0.05)。对晚期乳腺ILC患者与IDC患者的复发/转移特征进行比较,结果显示ILC患者的中位复发年龄为50岁(范围:28~73岁),IDC患者的中位复发年龄为51岁(范围:27~69岁);2组首次转移部位数目、淋巴结转移、内脏转移、肺转移和骨转移的差异均有统计学意义(P值均0.05)。ILC患者的中位无进展生存时间为14个月(范围:2~62个月),IDC患者的中位无进展生存时间为11个月(范围:1~89个月),2组的差异无统计学意义(P=0.121)。ILC患者的转移后中位生存时间为42个月(范围:5~78个月),IDC患者的转移后中位生存时间为44个月(范围:1~110个月),2组的差异无统计学意义(P=0.392)。多因素分析结果显示,孕激素受体状态、复发/转移年龄和骨转移治疗是晚期乳腺ILC患者预后的独立影响因素(P值均0.05);分子分型、首次转移部位数目和胸腔积液是晚期乳腺IDC患者预后的独立影响因素(P值均0.05)。结论:女性晚期乳腺ILC与IDC相比,前者显示出独特的临床病理、复发/转移和预后特征,应指导临床开展个体化的精准诊疗。
[Abstract]:Objective: to compare the clinicopathological features and prognostic factors of advanced invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC). Methods: a retrospective case-control study was conducted in 59 female patients with advanced breast ILC who were admitted to Tianjin Medical University Oncology Hospital from January 2008 to December 2016. In addition, according to the age of diagnosis and the time of operation (卤2 years), 236 female patients with advanced breast IDC were selected according to the ratio of 1:4. The differences of clinicopathological features and prognosis and prognostic factors were compared between the two groups. Results: in patients with advanced breast ILC and in patients with IDC, T staging, histological grading, estrogen receptor status, progesterone receptor status, and progesterone receptor status were observed. There were significant differences in the status and molecular typing of human epidermal growth factor receptor 2 (P < 0.05). The characteristics of recurrence / metastasis in patients with advanced breast ILC and those with IDC were compared. The results showed that the median age of recurrence in patients with ILC was 50 years old (range: 28 / 73). The median age of recurrence was 51 years (range: 2769 years). Lymph node metastasis, visceral metastasis, There were significant differences in lung metastasis and bone metastasis. The median progression-free survival time of patients with 0.05).ILC was 14 months (range: 2 ~ 62 months). Median progression free survival time of patients with 0.05).ILC was 11 months (range: 1 ~ 89 months). The median survival time after metastasis was 42 months (range: 5 ~ 78 months). The median survival time of IDC patients was 44 months (range: 1 ~ 110 months). There was no significant difference between the two groups. Multivariate analysis showed that progesterone receptor status, recurrence / metastasis age and bone metastasis were independent factors influencing the prognosis of advanced breast ILC patients (P = 0.05). The number of first metastatic sites and pleural effusion were independent factors influencing the prognosis of patients with advanced breast IDC (P = 0.05). Conclusion: compared with IDC, female advanced breast ILC shows unique clinicopathological features, recurrence / metastasis and prognosis, and should be guided by individualized and accurate diagnosis and treatment.
【作者单位】：天津医科大学肿瘤医院乳腺肿瘤内科国家肿瘤临床医学研究中心乳腺癌防治教育部重点实验室天津市恶性肿瘤临床医学研究中心天津市肿瘤防治重点实验室;
【基金】：国家科技支撑计划课题(编号:2015BAI12B15) 天津市卫生和计划生育委员会攻关项目(编号:16KG128)~~
【分类号】：R737.9

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