乳腺导管内乳头状瘤癌变151例患者临床分析  

Clinical analysis of 151 patients with carcinomatous change of breast intraductal papilloma

作　　者：张旭冉[1] 张丽娜[1] 顾林[1] 

机构地区：[1]天津医科大学肿瘤医院乳腺二科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,天津300060

出　　处：《肿瘤》2013年第12期1069-1073,共5页Tumor

基　　金：国家自然科学基金资助项目(编号:81202275);天津医科大学科学基金(编号:2011KY11)

摘　　要：目的 :分析乳腺导管内乳头状瘤癌变患者的临床病理特征及治疗和生存情况。方法 :回顾性分析1998年11月—2011年7月本院收治的151例乳腺导管内乳头状瘤癌变患者的病历资料和随访资料。根据病理诊断结果,将这151例患者分成癌变局限于导管内113例(74.8%)和癌变伴浸润38例(25.2%)。分析这些患者的临床病理特征及治疗和生存情况。结果 :癌变伴浸润患者发生乳头溢液的比例更高(P=0.036)。癌变伴浸润患者的Ki-67表达水平高于癌变局限于导管内患者(P=0.006);3年和5年无病生存率差异均无统计学意义(P>0.05)。结论 :癌变伴浸润患者的乳头溢液发生率较高,Ki-67表达水平也较高。早期发现和早期诊断对乳腺导管内乳头状瘤癌变患者的治疗和预后均有重要意义。Objective： To explore the clinicopathological features of patients with carcinomatous change of breast intraductal papilloma as well as the treatment protocols and the survival. Methods： The medical records and follow-up data of 151 patients with carcinomatous change of breast intraductal papilloma admmited to Cancer Hospital of Tianjin Medical University from November 1998 to July 2011 were retrospectively analyzed. These patients were categorized into two subgroups by pathology： carcinomatous change which was confined within duct （n = 113, 74.8%） and infiltrative carcinomatous change （n = 38, 25.2%）. The clinicopathological features, the treatment protocols and the survival were analyzed. Results： The rate of nipple discharge in patients with infiltrative carcinomatous change was higher than that in patients with carcinomatous change confined within duct （P = 0.036）. The expression level of Ki-67 was higher in infiltrative carcinomatous change than in carcinomatous change confined within duct （P = 0.006）. The three-year and five-year disease-free survival rates were not significantly different between these two pathological types （P 〉 0.05）. Conclusion： In carcinomatous change of breast intraductal papilloma, the patients with infiltrative carcinomatous change have a lower rate of nipple discharge and a higher expression level of Ki-67. Early detection and early diagnosis are essential to the treatment of carcinomatous change of breast intraductal papilloma and may improve its prognosis.

关 键 词：乳腺肿瘤 导管内乳头状瘤 生存分析 

分 类 号：R737.9[医药卫生—肿瘤]