乳腺浸润性小叶癌的临床病理特征  

Clinicopathologic characteristics of invasive lobular carcinoma of the breast

作　　者：李丽[1] 孟刚[1] 汪小霞[1] 王岳君[1] 杨苗苗[1] 陈青[1] 黄雯[1] 韩彪[1] 

机构地区：[1]安徽医科大学病理学教研室,合肥230032

出　　处：《临床与实验病理学杂志》2015年第4期390-394,399,共6页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨乳腺浸润性小叶癌(invasive lobular carcinoma,ILC)的临床病理特征及其预后因素。方法回顾性分析98例ILC和530例乳腺非特殊型浸润性癌患者的临床病理资料,观察ILC的临床病理特征及其预后因素。结果 ILC和非特殊型浸润性癌的中位随访时间分别为68.5、67个月。与非特殊型浸润性癌相比,ILC患者就诊时年龄较大,肿瘤较大,组织学分级多为2级,ER、PR阳性率高,HER-2多为阴性,Ki-67增殖指数较低,分子分型多为管腔A型(P<0.001)。ILC中,经典型ILC肿瘤较小,组织学分级较低,Ki-67增殖指数较低,分子分型中管腔A型较多;非经典型ILC中管腔B型、三阴型和HER-2过表达型较多(P=0.035)。单因素分析显示经典型与非经典型ILC的无病生存率和总生存率差异均有统计学意义(P=0.043,P=0.048);ILC与非特殊型浸润性癌的无病生存率和总生存率差异无统计学意义(P=0.537,P=0.397);多因素分析显示,ILC中管腔A型患者的总生存率明显高于三阴型和HER-2过表达型(P=0.016,P=0.015)。结论 ILC的预后和组织学分型与分子分型有关,应为预后较差的患者探寻新的治疗策略。Purpose To investigate the clinicopathological characteristics and the survival outcomes of invasive lobular carcinoma. Methods A retrospective analysis of 98 patients with invasive lobular carcinoma and 530 invasive carcinoma of no special type was performed in order to observe the histological features and the clinical outcomes of invasive lobular carcinoma. Results Median follow- up was 68.5 months for invasive lobular carcinoma and 67 months for invasive carcinoma of no special type. Invasive lobular carcinoma presented with a larger tumor size, more histopathological grade 2 tumors, increased rate of hormonal receptor positivity, human epider- mal growth factor 2 （HER-2） negativity, and had a lower proliferative index as compared to invasive carcinoma of no special type, more frequently presented with the luminal A subtype （P 〈0. 001 ）. The classical invasive lobular carcinoma presented with a smaUer tumor size, to have a lower histological grade and proliferative index compared to the non-classic type, and more frequently presented with the luminal A subtype, whereas the non-classic invasive lobular carcinoma patients more frequently presented with the luminal B, HER-2 overexpression, or triple negative subtype （ P = 0. 035 ）. A statistically significant difference in the outcome was observed at un- ivariate analysis for patients with non-classic for disease-free survival （P =0. 043） and for overall survival （P =0. 048）, as compared with patients with classical invasive lobular carcinoma. The disease-free survival difference between the invasive lobular carcinoma and the invasive carcinoma of no special type was not significant （P = 0. 537）, and the overall survival rates were not statistically different between the two groups （P = 0. 397）. A statistically significant difference of overall survival was observed at multivariate analysis for patients with HER-2 positive and triple negative subtypes versus patients with luminal A invasive lobular carcinoma （P = 0. 015, P = 0. 01

关 键 词：乳腺肿瘤 浸润性小叶癌 非特殊型浸润性癌 临床病理特征 分子分型 预后 

分 类 号：R737.9[医药卫生—肿瘤]