94例纯型乳腺黏液腺癌的临床分析  

Clinical Analysis of 94 Patients with Pure Mucinous Breast Carcinoma

作　　者：傅月荷 陈洁[1] 谭秋雯 田春祥[1] 吕青[1] 

机构地区：[1]四川大学华西医院甲状腺乳腺外科,四川成都610041

出　　处：《中国普外基础与临床杂志》2015年第9期1083-1090,共8页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结纯型乳腺黏液腺癌（PMBC）的临床病理学特点，并分析其预后及其影响因素。方法回顾性分析四川大学华西医院1996年11月至2011年10月期间收治的经病理学诊断为PMBC的94例患者的临床病理学资料，以及其长期随访结果。结果①临床病理学特征：本组94例PMBC患者占四川大学华西医院同期乳腺癌的1．48％（9416330），均为女性，中位年龄为45岁（29-85岁），中位病程为90d（5～2920d），有63．83％的患者（60／94）尚未绝经；98．94％的患者为单侧PMBC（93／94），1．06％的患者为同时双侧PMBC（1／94），共计95个病灶。有85．29％（58／68）的病灶T分期为T1＋T2期，有82．80％（77／93）的病灶未出现淋巴结转移，1．05％（1／95）的病灶就诊时已出现远处转移，92．54％的病灶（62／67）处于Ⅰ＋Ⅱ期，雌激素受体（ER）、孕激素受体（PR）及人类表皮生长因子受体．2基因（HER．2／neu）阳性的病灶分别占84．34％（70／83）、74．70％（62／83）和20．25％（16／79）；保乳率为6．32％（6／95）。②术前诊断：单纯乳腺X片、单纯彩超检查及乳腺X线＋彩超检查的恶性肿块检出率分别为60．87％（14／23）、83．33％（40／48）及100％（18／18），三者比较差异有统计学意义（p=0．006）。③预后及其影响因素：术后76例患者获访，随访率为80．85％，中位随访时间为60个月（19-188个月）。随访期间，有2例患者发生远处转移，其中1例患者死亡。获访患者的5年及10年总生存率均为98．50％，5年及10年无复发生存率均为95．80％。T1期患者均无淋巴结累及，随访中未曾出现复发、转移或者死亡。生存分析的单因素分析结果表明，病程、肿瘤T分期、TNM分期及HER-2／neu基因表达情况均是无复发生存的影响因素（p〈0．050）。结论本组PMBC患者较欧美国家有发病年龄较小、绝经前患者�Objective To summarize the clinicopathological characteristics of 94 patients with pure mucinous breast carcinoma （PMBC）, and to retrospectively analyze the prognosis and the prognostic factors. Methods Ninety four patients who were pathologically diagnosed with PMBC from November 1996 to October 2011 were retrieved from the database of breast cancer in West China Hospital. The clinicopathological and long term follow-up data of these patients were analyzed retrospectively. Results （1） Clinicopathological characteristics： These patients accounted for 1.48% （94/6 330） of all breast cancer patients who treated in our hospital during the same period. They were all female, with a median age of 45 years old （29-85 years） and median duration of 90 d （5-2920 d）. A proportion of 63.83% （60/94） of these patients were premenopausal women. Ninety three patients had unilateral lesion, one patient had bilateral lesions, totally 95 lesions. A proportion of 85.29% （58/68） tumors were in T1-T2 staging, and 82.80% （77/93） tumors were node- negative. A proportion of 1.05% （1/95） tumors had metastasized at diagnosis. A proportion of 92.54% （62/67） tumors were in Ⅰ - Ⅱ staging, 84.34% （70/83） tumors were estrogen receptor （ER） positive, 74.70% （62/83） were progesterone receptor （PR） positive, and 20.25% （16/79） were human epidermal growth factor receptor 2 （HER-2/neu） positive. Aproportion of 6.32% （6/95） of tumors had breast-conserving surgery. （2） Preoperative diagnosis： The detection rate of malignance were 60.87% （14/23）, 83.33% （40/48）, and 100% （18/18）, respectively for patients who were examined with mammography, ultrasonography, and mammography＋ultrasonography, and there was significant difference between the three groups （P=0.006）. （3） Prognosis and prognostic factors： The follow-up rate was 80.85% （76/94）. Two cases had bone metastasis respectively in 14 and 26 months after operation, one of whom died. Both five-year

关 键 词：纯型乳腺黏液腺癌 临床病理学特征 预后 影响因素 

分 类 号：R737.9[医药卫生—肿瘤]