乳腺黏液腺癌临床病理特征及预后  

Clinicopathological characteristics and prognosis of mucinous breast carcinoma

作　　者：陈宏亮[1] 丁昂[1] 王懋莉[1] 张征[1] 

机构地区：[1]复旦大学附属妇产科医院乳腺外科,上海200011

出　　处：《中华普通外科杂志》2016年第3期180-184,共5页Chinese Journal of General Surgery

摘　　要：目的 研究乳腺黏液腺癌（mucinous breast carcinoma,MBC）的临床病理特征及预后.方法 回顾性分析2005年1月至2014年12月复旦大学附属妇产科医院乳腺外科手术治疗并有完整病例资料的MBC 112例,纯型（pure MBC,PMBC） 71例,混合型（mixed MBC,MMBC）41例,两者相互比较,并分别与同期1 157例浸润性导管癌（invasive ductal carcinoma,IDC）对比.结果 PMBC较IDC肿块小、激素受体表达率高（均P＜0.05）、淋巴结转移率低（7.0％比40.6％,X2=32.663,P＜0.001）;PMBC 5年无病生存（disease free survival,DFS）及总生存（overall survival,OS）率高于IDC（DFS：94.6％±3.0％比81.3％±1.1％,x2=7.265,P =0.007;OS：92.4％±5.3％比88.5％±1.0％,X2=4.059,P=0.044）.MMBC较IDC肿块大、激素受体表达率高,但淋巴结转移率差异无统计学意义（48.8％比40.6％,x2=3.417,P=0.332）;MMBC 5年DFS及OS与IDC差异无统计学意义（DFS：79.1％±7.1％比81.3％±1.1％,X2=0.167,P =0.683;OS：84.5％±7.2％比88.5％±1.0％,x2 =0.123,P=0.726）.PMBC较MMBC肿块小、淋巴结转移率低,激素受体表达率差异无统计学意义;PMBC 5年DFS及OS高于MMBC（DFS：94.6％ ±3.0％比79.1％±7.1％,X2=6.772,P=0.009;OS：92.4％±5.3％比84.5％±7.2％,X2=6.401,P=0.036）.多因素分析得出淋巴结状态是MBC唯一的预后因素.结论 PMBC淋巴结转移率低,预后优于MMBC及IDC;MMBC淋巴结转移率高于PMBC,预后与IDC差异无统计学意义.Objective To evaluate the clinicopathological characteristics of mucinous breast carcinoma （MBC） and its prognosis.Methods 112 cases of MBC treated in Obstetrics and Gynecology Hospital of Fudan University between Jan 2005 and Dec 2014 were enrolled retrospectively together with 1 157cases of invasive ductal carcinoma （IDC） for comparison.There were 71 cases of pure MBC （PMBC） and 41cases of mixed MBC （MMBC）.PMBC and MMBC were compared with each other,and were also compared with IDC respectively.Results PMBC had smaller tumor mass,higher expression rate of hormone receptors （all P〈0.05）,lower rate of lymph node metastasis （7.0% vs.40.6%,x2 =32.663,P 〈0.001） when compared with IDC.The 5 year disease free survival （DFS） and overall survival （OS） of PMBC were both better than those of IDC （DFS：94.6% ±3.0% vs.81.3% ± 1.1%,x2 =7.265,P =0.007;OS：92.4% ±5.3% vs.88.5% ± 1.0%,x2 =4.059,P =0.044）.MMBC had relatively larger tumor mass,higher expression rate of hormone receptor,but had no difference in the rate of lymph node metastasis （48.8% vs.40.6%,x2 =3.417,P =0.332） when compared with IDC.There was no statistically significant difference in 5 yearDFSandOSbetweenMMBCandIDC （DFS：79.1% ±7.1% vs.81.3%±1.1%,x2 =0.167,P=0.683;OS：84.5% ±7.2% vs.88.5% ± 1.0%,x2 =0.123,P =0.726）.PMBC had relatively smaller tumor mass,lower rate of lymph node metastasis,but had no difference in the expression rate of hormone receptors.The 5 year DFS and OS of MMBC were both better than those of MMBC （DFS：94.6% ± 3.0% vs.79.1%±7.1%,x2 =6.772,P =0.009;OS：92.4% ±5.3% vs.84.5% ±7.2%,x2 =6.401,P=0.036）.Lymph node status was the only statistically significant prognostic factor of MBC by COX multivariate analysis.Conclusions PMBC has better prognosis than MMBC and IDC owing to its lower rate of lymph node metastasis.MMBC has higher rate of node metastasis than PMBC,hence similar prognosis with IDC.

关 键 词：乳腺肿瘤 病理学 临床 预后 

分 类 号：R735.2[医药卫生—肿瘤]