化生性乳腺癌26例临床分析  

Metaplastic Breast Cancer:Clinical Analysis of 26 Cases

作　　者：冉冉 刘姗灵 涂刚[1] Ran Ran;Liu Shanling;Tu Gang(Department of Breast and Endocrine Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院内分泌乳腺外科

出　　处：《肿瘤预防与治疗》2019年第10期894-899,共6页Journal of Cancer Control And Treatment

摘　　要：目的:探讨化生性乳腺癌的临床病理特征及预后分析。方法:回顾性分析2014~2018年诊治入院的26例化生性乳腺癌患者临床病理资料,并参考有关文献进行分析讨论。结果:入组患者中位年龄49岁,乳房肿块平均直径(3. 9±1. 8) cm。雌激素受体、孕激素受体和人表皮生长因子受体-2均呈阴性者23例,占88. 5%(23/26)。共25例行手术治疗,5例患者行术前新辅助化疗,其中4例临床疗效达部分缓解,1例临床进展。16例患者接受术后化疗,7例患者接受术后放疗,中位随访时间16. 5月(4~56月),1例患者于术后2月发生胸壁转移,6例患者分别于7~36个月发生远处转移,2年总生存率和无病生存率分别为69. 5%和72. 7%。术后化疗和未化疗患者的中位生存期差异无统计学意义(15. 0个月vs 17. 0个月,P=0. 865)。不同病理类型化生性乳腺癌的局部复发、远处转移和死亡率差异无统计学意义(P> 0. 05)。结论:化生性乳腺癌是一类罕见的特殊类型乳腺癌,分子分型主要表现为三阴性,具有侵袭性高、预后差等特点,目前除手术治疗以外,全身治疗以化疗为主,但化疗疗效尚存争议。Objective:To discuss the clinicopathological features of metaplastic breast cancer and analyze the prognosis of it.Methods:We retrospectively analyzed 26 metaplastic breast cancer patients in the First Affiliated Hospital of Chongqing Medical University from 2014 to 2018 and reviewed related articles about this cancer.Results:The median age was 49 years old.The average diameter of breast mass was 3.9±1.8 cm.A total of 23 cases expressed negative estrogen receptor,pro-gesterone receptor and human epidermal growth factor receptor-2,accounting for 88.5%(23/26)of all cases.In total,25 cases accepted surgery,5 were treated with neoadjuvant chemotherapy before operation.Among them,4 got partial response,1 got progressive disease.Besides,16 cases accepted postoperative chemotherapy,and 7 cases postoperative radiotherapy.No significant difference was found in the median survival time between patients receiving postoperative chemotherapy and those without postoperative chemotherapy(15.0 month vs 17.0 month,P=0.865).The median follow-up time was 16.5 months.Local recurrence occurred in 1 case two months after surgery,and distant metastasis occurred in 6 cases 7 to 36 months after operation.Two-year overall survival rate and disease-free survival rate were 69.5%and 72.7%,respectively.But no significant differences were found in local recurrence,distant metastasis and mortality among different pathological types of metaplastic breast cancer(P>0.05).Conclusion:Metaplastic breast cancer is a rare molecular typing of triple negative breast cancer,which is characterized by high aggressiveness and poor prognosis.In addition to surgery,chemothera-py is the main systemic treatment,but the efficacy is still controversial.

关 键 词：化生性乳腺癌 临床分析 病理 治疗 预后 

分 类 号：R737.9[医药卫生—肿瘤] R730.4[医药卫生—临床医学]