本文選題：乳腺癌　切入點(diǎn)：浸潤(rùn)性微乳頭狀癌　出處：《中華腫瘤防治雜志》2017年09期 　論文類(lèi)型：期刊論文

【摘要】：目的乳腺浸潤(rùn)性微乳頭狀癌(invasive micropapillary carcinoma,IMPC)是一種特殊類(lèi)型的乳腺浸潤(rùn)性癌,易發(fā)生淋巴管、血管侵犯,但對(duì)其預(yù)后的認(rèn)識(shí)仍存在分歧。本研究擬探討IMPC的臨床病理特征及預(yù)后相關(guān)性,為臨床治療提供指導(dǎo)。方法采用回顧性分析的方法,形態(tài)學(xué)觀察并評(píng)估2006-06-19-2015-10-28國(guó)家癌癥中心中國(guó)醫(yī)學(xué)科學(xué)院腫瘤醫(yī)院病理確診的89例乳腺I(mǎi)MPC中微乳頭狀結(jié)構(gòu)的比例,應(yīng)用免疫組化方法檢測(cè)ER、PR、HER2及Ki-67的表達(dá),并對(duì)各臨床病理因素進(jìn)行生存分析。結(jié)果腫瘤內(nèi)微乳頭狀癌比例50%組ER陽(yáng)性率為85.7%,高于微乳頭狀癌比例25%~50%組(57.1%)和25%組(40%),P=0.013;單純性IMPC組伴脈管瘤栓比率為58.8%,高于混合性IMPC組的32.4%,P=0.018。隨訪(fǎng)資料顯示,微乳頭狀癌比例50%組復(fù)發(fā)/轉(zhuǎn)移率為9.1%,低于微乳頭狀癌比例25%~50%組(28.6%)和25%組(40.0%),P=0.047。Kaplan-Meier單因素生存分析顯示,微乳頭狀癌成分50%組無(wú)瘤生存期長(zhǎng)于微乳頭狀癌成分25%~50%組與25%組,χ~2=4.296,P=0.038;ER陽(yáng)性組無(wú)瘤生存期長(zhǎng)于ER陰性組,χ~2=5.324,P=0.021;原發(fā)腫瘤T1組無(wú)瘤生存期長(zhǎng)于T2組,χ~2=7.302,P=0.026。Cox多因素生存分析未發(fā)現(xiàn),影響乳腺I(mǎi)MPC無(wú)瘤生存時(shí)間的獨(dú)立預(yù)后因素。結(jié)論乳腺I(mǎi)MPC雖然易于發(fā)生脈管侵犯,但其侵襲性、轉(zhuǎn)移能力及惡性度并不因而增高;原發(fā)腫瘤大小、ER狀態(tài)、微乳頭癌比例可能與其預(yù)后相關(guān),但有待擴(kuò)大樣本及更長(zhǎng)期隨訪(fǎng)數(shù)據(jù)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.
【作者單位】： 國(guó)家癌癥中心·中國(guó)醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院腫瘤醫(yī)院乳腺外科;國(guó)家癌癥中心·中國(guó)醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院腫瘤醫(yī)院病理科;
【分類(lèi)號(hào)】：R737.9

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