摘要
目的 探讨乳腺浸润性小叶癌的临床病理学特征及预后因素.方法 回顾性分析2008年1月至2014年12月北京大学第一医院乳腺疾病中心收治的68例乳腺浸润性小叶癌患者的临床病理学资料,占同期收治的浸润性乳腺癌总数的3.64％（68/1870）.患者均为女性,年龄36～83岁,中位年龄46岁.参照AJCC第8版乳腺癌分期系统进行解剖学分期和预后分期,并对两种分期进行比较,采用Kaplan-Meier法计算5年总体生存率和无病生存率,采用Log-rank检验对临床病理特征与预后的相关性进行单因素分析.结果 乳腺浸润性小叶癌的解剖学分期、预后分期、淋巴结转移、孕激素受体及人体表皮生长因子受体2表达情况、Ki-67水平、组织学分级和脉管癌栓对无病生存率有影响（χ2为4.347～27.369,P值均〈0.05）;解剖学分期、预后分期、淋巴结转移、孕激素受体表达情况、脉管癌栓和神经侵犯对于总体生存率有影响（χ2为4.318～32.394,P值均〈0.05）.36例（52.9％）患者预后分期与解剖学分期相比发生变化;其中Luminal型分期变化以下降为主（22/30）,三阴型分期变化以上升为主（6/6）.结论 乳腺浸润性小叶癌的解剖学分期、预后分期、淋巴结转移、孕激素受体表达情况和脉管癌栓与预后相关.乳腺浸润性小叶癌患者AJCC第8版预后分期与解剖学分期之间的差异值得临床关注.
Objective To study the clinicopathological characteristics and the prognostic determinants of the invasive lobular carcinoma breast cancer. Methods This was a retrospective single-center study of invasive lobular breast cancer cases diagnosed from January 2008 to December 2014 at Peking University First Hospital Breast Disease Center. The study enrolled 68 invasive lobular breast cancer patients, which represented 3. 64% （ 68/1870 ） of total invasive breast cancer. The median age of all selected patients was 46 years ranging from 36 to 83 years. All patients were restaged based on the 8th edition of AJCC cancer staging system and follow-up data including disease-free survival （ DFS） and overall survival （ OS） were analyzed to explore the prognostic determinants. The 5-year OS and DFS were calculated using Kaplan-Meier method; the significance of correlations between clinicopathological features and prognostic factors was estimated using log-rank test. Results There were significant differences in OS between patients with different anatomic stage, prognostic stage, lymph node metastasis, progesterone receptor （ PR ） expression, lymphvascular invasion and perineural invasion （χ2： 4. 318 to 32. 394, all P〈 0. 05 ）;significant differences in DFS were also observed between patients with different anatomic stage, prognostic stage, lymph node metastasis, PR expression, human epidermal growth factor receptor-2 expression, Ki-67 level, histological grade and lymphvascular invasion （χ2：4. 347 to 27. 369, all P〈0. 05）. Prognostic stages of 52. 9% patients changed compared with anatomic stage, among which Luminal subtype mainly downstaged （22/30）, however, triple negative subtype mainly upstaged （ 6/6）. Conclusions Anatomic stage, prognostic stage, lymph node metastasis, PR expression, lymphvascular invasion are the prognostic factors of invasive lobular breast cancer. Regard to invasive lobular breast cancer patients, clinicians should pay close attention to the differences between prognostic stage and anatomic stage.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2018年第2期119-123,共5页
Chinese Journal of Surgery
基金
国家重点研发计划资助项目（2016YFC0901302）
首都医学发展科研基金项目（2009-1011）
首都临床特色应用研究项目（Z131107002213007）
关键词
乳腺肿瘤
肿瘤分期
预后
Breast neoplasms
Neoplasm staging
Prognosis
