乳腺原发神经内分泌癌的临床病理特点分析  

Analysis of the clinicopathological characters of primary neuroendocrine breast carcinomas

作　　者：华彬[1] 张伟[2] 陆旭[1] 杨鑫[1] 何淑荣 肖文政[1] 牛小娟[1] HUA Bin;ZHANG Wei;LU Xu;YANG Xin;HE Shu-rong;XIAO Wen-zheng;NIU Xiao-juan(Breast Center, Beijing Hospital, National Center of Gerontology, Beij＇ing 100730, China;Department of Pathology, Beijing Hospital, National Center of Gerontology, Beij＇ing 100730, China)

机构地区：[1]国家老年医学中心、北京医院乳腺中心,北京100730 [2]国家老年医学中心,北京医院病理科,北京100730

出　　处：《中国医刊》2018年第5期522-527,共6页Chinese Journal of Medicine

摘　　要：目的探讨乳腺原发神经内分泌癌(neuroendocrine breast carcinoma,NEBC)的临床病理特点。方法回顾性分析北京医院乳腺中心2008年6月至2017年6月连续收治的27例NEBC患者,总结NEBC的临床病理特点,初步分析NEBC患者的生存状态。结果 27例患者均为女性,年龄45～92岁,中位年龄71岁,占同期收治乳腺癌患者的1.4%(27/1923)。术后病理诊断分化良好型6例,分化差或小细胞型7例,浸润性乳腺癌伴神经内分泌化14例;淋巴结转移率30.77%(8/26);96.30%(26/27)的患者为肿瘤早期,可接受手术治疗;组织学分级1级、2级患者占77.78%(21/27)。雌激素受体(estrogen receptor,ER)阳性率为92.59%(25/27),孕激素受体(progesterone receptor,PR)阳性率为85.19%(23/27)。55.56%(15/27)的患者接受了蒽环联合紫杉方案化疗。随访4～99个月,中位无病生存时间为84.23个月(95%CI 71.84～96.62),中位总生存时间为85.91个月(95%CI73.65～98.18)。结论 NEBC是一种少见的特殊类型乳腺癌,目前尚无特异性的治疗方案;NEBC高表达ER、PR,内分泌治疗具有重要价值;患者总体预后尚可。Objective To investigate the clinicopathologic characters of neuroendocrine breast cancer （NEBC）. Method We retrospectively collected all data of patients with NEBC in Breast Center of Beijing Hospital from June 2008 to June 2017 and analyzed the characters and survival of all the 27 consecutive female patients. Result 27 patients with NEBC were admitted from June 2008 to June 2017 and the incident in our center was 1.4% （27/1923）. The median age was 71 years old. There were 6 well differentiated cases, 7 small cells or poorly differentiated ones and 14 invasive breast carcinoma with neuroendocrine differentiation cases. The rate of lymph nodes metastasis was 30.77% （8/26）. 26 cases were definitely operable early stage , and 77.78% （21/27） cases were histological grade 1 and 2. The expression of ER was 92.59% （25/27）, and PR was 85.19% （23/27）. 55.56% （15/27） patients received chemotherapy with anthracycline and paclitaxel based regiments. Endocrine therapy was the main system treatment for these patients because of the high expression of ER/PR. The median disease free survival was 84.23 months（95%CI 71.84-96.62）,and the median overall survival was 85.91 months（95%CI 73.65-98.18）. Conclusion NEBC was a kind of very rare entity of mammary neoplasms. Endocrine therapy might be an important regiment for these candidates because of the high expression of ER/PR. The prognosis of NEBC was relatively good.

关 键 词：乳腺癌 神经内分泌癌 预后 

分 类 号：R737.9[医药卫生—肿瘤]