22例乳腺原发性鳞状细胞癌临床病理特征及预后分析  

Clinicopathological features and prognostic factors of 22 cases of primary squamous cell carcinoma of the breast

作　　者：张艳琦[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乳腺癌防治教育部重点实验室天津市肿瘤防治重点实验室,300060

出　　处：《中华肿瘤杂志》2015年第4期293-296,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金（81202275）

摘　　要：目的探讨乳腺原发性鳞状细胞癌的临床病理特征和预后。方法回顾性分析1985年1月至2011年1月诊治的22例乳腺原发性鳞状细胞癌的临床资料，分析患者的临床病理特征与预后的关系。采用Cox比例风险回归模型分析影响患者预后的因素。结果22例乳腺原发性鳞状细胞癌患者均为女性，中位年龄为56岁。平均肿瘤最大直径为3．6cnq。雌激素受体、孕激素受体和人表皮生长因子受体2的阳性表达率分别为9．1％、9．1％和33．3％。5例患者发生复发或转移，均因肿瘤复发转移死亡。22例患者的中位生存时间为60个月，5年生存率为73．6％。单因素分析结果显示，肿瘤最大直径和腋下淋巴结转移是影响患者预后的因素（均P〈0．05），而患者绝经与否、化疗和放疗与预后无关（均P〉0．05）。多因素分析结果显示，肿瘤最大直径和腋下淋巴结转移是影响患者预后的独立因素（均P〈0．05）。结论乳腺原发性鳞状细胞癌的发病率低，临床特征缺乏特异性。腋下淋巴结转移是影响患者预后的独立因素。Objective To investigate the clinicopathological features and prognosis of primary squamous cell carcinoma of the breast and to improve the diagnosis, treatment and prognosis of this disease. Methods The clinicopathological data of 22 patients with primary squamous cell carcinoma of the breast treated in our hospital between January 1985 and January 2011 were retrospectively reviewed. The correlation between age, tumor size, axillary node status, treatment modality and prognosis was statistically analyzed. Results All the 22 patients were female and their median age was 56 years.The average tumor diameter was 3.6 cm.The diagnosis was confirmed by histopathology. The positive rates of expression of ER, PR and HER- 2 of the breast cancers were 9.1%, 9.1% and 33.3%, respectively. In follow-up visits, recurrence or metastasis was found in 5 patients and they all died of it. The median overall survival of the 22 patients was 60 months and their overall 5-year survival rate was 73.6%. Univariate analysis showed that the tumor maximum diameter（P = O. 024） and axillary lymph node status （P = 0. 022） were impact factors, while menopause ,chemotherapy and radiotherapy were not. Cox multivariate analysis showed that the tumor size （P=0.021） and axillary lymph node status （P = 0.037） were independent prognostic factors for primary squamous cell carcinoma of the breast. Conclusions Primary squamous cell carcinoma of the breast is a rare entity and lack of specific clinical features. Axillary node status is an independent prognostic factor.

关 键 词：乳腺肿瘤 癌 鳞状细胞 病理学 临床 诊断 治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]