本文關(guān)鍵詞： 乳腺粘液癌 臨床病理特征 預(yù)后 少細胞型乳腺粘液癌 富于細胞型乳腺粘液癌 混合型乳腺粘液癌　出處：《吉林大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討是否不同類型的乳腺粘液癌(Mucinous breast carcinoma,MBC)均有相同的預(yù)后,是否應(yīng)根據(jù)乳腺粘液癌的亞分類來制定個體化的治療策略。方法:本研究回顧性分析了2005年5月到2015年12月期間共136例在吉林大學第一醫(yī)院行手術(shù)治療的MBC患者的病例資料,并將2062例同期診斷為非特殊類型乳腺導管癌(Invasive ductal carcinoma-not otherwise specified,IDC-NOS)的病例設(shè)為對照組,比較兩者的臨床病理學特征及不同乳腺粘液癌亞型與IDC-NOS間的生存差異。結(jié)果:與IDC-NOS相比,MBC具有病理分期早,腫瘤直徑大,淋巴結(jié)轉(zhuǎn)移率低,ER、PR陽性率高,Her-2陽性率低,Ki-67低表達率高及預(yù)后好的特點。PMBC具有比MMBC更早的病理分期、更低的淋巴結(jié)轉(zhuǎn)移率和組織學分級,且接受保乳手術(shù)和放射治療的患者更多,接受化學治療的患者更少。IDC-NOS、MMBC、PMBC-B、PMBC-A的5年DFS分別為85.9%、85.2%、96.8%、100%,5年OS分別為89.4%、89.8%、100%、100%�；趤喎诸愊啾�,PMBC具有比IDC-NOS更好的DFS(P=0.009)和OS(P=0.015),PMBC具有比MMBC更好的DFS(P=0.006)和OS(P=0.009)。PMBC-A具有比IDC-NOS更好的DFS(P=0.015)和OS(P=0.035),PMBC-A具有比MMBC更好的DFS(P=0.013)和OS(P=0.039)。PMBC-B與MMBC、IDC-NOS之間的DFS和OS則無統(tǒng)計學差異。MMBC、PMBC-B、PMBC-A三組的DFS(P=0.016)和OS(P=0.028)差異具有統(tǒng)計學意義。對于II期的MBC和IDC-NOS患者,MBC顯示出比IDC-NOS更好的DFS(P=0.048)。對于年齡≤51歲的MBC和IDC-NOS患者,MBC顯示出比IDC-NOS更好的DFS(P=0.041)。結(jié)論:1.與IDC-NOS相比,MBC的病理分期更早,腫瘤直徑更大,淋巴結(jié)轉(zhuǎn)移率更低,ER、PR陽性率更高,Her-2陽性率更低,Ki-67低表達率更高,但預(yù)后差異無統(tǒng)計學意義。2.與MMBC相比,PMBC的病理分期更早、淋巴結(jié)轉(zhuǎn)移率更低和組織學分級更低,接受保乳手術(shù)的患者更多,接受化學治療和放射治療的患者更少,預(yù)后更好。3.PMBC-A型與IDC-NOS及MMBC相比,其預(yù)后更好;但PMBC-B型與IDC-NOS及MMBC相比,其預(yù)后差異無統(tǒng)計學意義。4.TNM分期和ER狀態(tài)是影響MBC患者DFS的獨立預(yù)后因素。淋巴結(jié)狀態(tài)、ER狀態(tài)、年齡是影響MBC患者OS的獨立預(yù)后因素。因此,并非所有的MBC均為具有良好預(yù)后的組織學類型,應(yīng)考慮基于亞分類,制定相應(yīng)的治療策略。
[Abstract]:Objective: to investigate whether different types of mucinous breast carcinoma of the breast have the same prognosis. Whether individual treatment strategies should be developed based on the subclassification of breast mucinous carcinoma. Methods:. This study retrospectively analyzed the data of 136 MBC patients who underwent surgical treatment in the first Hospital of Jilin University from May 2005 to December 2015. 2062 cases were diagnosed as non-special type breast ductal carcinoma at the same time. Invasive ductal carcinoma-not otherwise specified. IDC-NOS was used as the control group to compare the clinicopathological characteristics of the two groups and the survival differences between the two subtypes of breast mucinous carcinoma and IDC-NOS. Results: compared with IDC-NOS. MBC had early pathological stage, large tumor diameter, low lymph node metastasis, high positive rate of ERP and low positive rate of Her-2. The characteristics of low expression rate and good prognosis of Ki-67. PMBC has earlier pathological stage, lower lymph node metastasis rate and lower histological grade than MMBC. More patients received breast conserving surgery and radiotherapy, and fewer patients received chemotherapy. The 5 year DFS of PMBC-A was 85.9% and the value of 85.2% was 96.8100%. In 5 years OS was 89.4% and 89.8%, respectively. Compared with subtaxonomy, PMBC has a better IDC-NOS P0. 009 and OSP0. 015). PMBC is better than MMBC P0. 006) and OS(P=0.009).PMBC-A is better than IDC-NOS. And OSG P0. 035). PMBC-A has better OS(P=0.039).PMBC-B and MMBC than MMBC. There was no statistical difference between DFS and OS between IDC-NOS. There was a statistically significant difference in PMBC-A between the three groups (MBC 0.016) and IDC-NOS (0.028). For patients with MBC and IDC-NOS in stage II, there was a significant difference between the two groups. MBC showed better than IDC-NOS in patients with MBC and IDC-NOS, who were less than 51 years old. Compared with IDC-NOS, MBC showed a better pathological stage and larger tumor diameter than that of IDC-NOS. Conclusion: (1) compared with IDC-NOS, the pathological stage of MBC is earlier and the diameter of the tumor is larger than that of IDC-NOS. Lower lymph node metastasis rate higher positive rate of ERN PR higher positive rate of Her-2 lower Ki-67 lower expression rate but no significant difference in prognosis. 2. Compared with MMBC. PMBC had earlier pathological staging, lower lymph node metastasis and lower histological grade, more breast conserving surgery, and less chemotherapy and radiotherapy. The prognosis of PMBC-A was better than that of IDC-NOS and MMBC. But the PMBC-B type was compared with IDC-NOS and MMBC. TNM stage and ER status were independent prognostic factors of DFS in patients with MBC. Age is an independent prognostic factor for OS in patients with MBC. Therefore, not all MBC are histologic types with good prognosis.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.9

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