乳腺大汗腺分化癌伴浸润性导管癌的临床病理特征及预后分析  

Clinicopathological features and prognosis of breast apocrine carcinoma and infitrating ductal carcinoma

作　　者：潘燕芳 郑妮 孙奇 黄忠光 PAN Yan-fang;ZHENG Ni;SUN Qi;HUANG Zhong-guang(Department of Pathology,Liuzhou Iron and Steel Corporation Hospital,Liuzhou 545002,China;Liuzhou Worker's Hosoital,Liuzhou 545005,China;Department of Oncology,Liuzhou Iron and Steel Corporation Hospital,Liuzhou 545002,China)

机构地区：[1]柳州钢铁集团有限公司医院病理科,广西柳州545002 [2]柳州市工人医院病理科,广西柳州545005 [3]柳州钢铁集团有限公司医院肿瘤科,广西柳州545002

出　　处：《诊断病理学杂志》2019年第12期835-838,843,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺伴大汗腺分化癌伴浸润性导管癌的临床病理特征及预后特点。方法回顾性分析大汗腺分化癌(ACB)30例、乳腺浸润性导管癌(IDC)30例及乳腺大汗腺分化癌伴浸润性导管癌(ACB伴IDC)30例临床病理资料,并比较3组患者的病理特征与预后的关系。结果①ACB伴IDC患者的平均年龄相对较高(57.23±3.51岁),与ACB患者比平均年龄差异不大,显著高于IDC患者平均年龄(50.17±5.62岁)(P<0.05);ACB伴IDC的病理分期以II、III级为主,组织学分级以II级为主,与其他两组比较均差异显著(P<0.05)。②3年内ACB伴IDC的骨转移率66.7%,区域淋巴结转移率43.3%,远处转移率46.7%,均高于其他两组(P<0.05)。ACB伴IDC的首次转移平均时间为12.2±2.1个月,首次复发平均时间为13.6±3.3个月,显著低于其他两组(P<0.05)。③3年内,ACB伴IDC组死亡5例,死亡率16.7%,显著高于其他两组;首例死亡时间为第13个月。ACB和IDC各出现死亡1例(3.3%)和2例(6.7%),首例出现死亡时间为第24个月和第17个月。ACB伴IDC的无病生存期(DFS)与总生存期(OS)平均周期为14.6±3.7个月、23.2±2.2个月,显著低于其他两组(P<0.05)。④ACB伴IDC的ER、PR及Her2阳性均高于其他两组(P<0.05);所有的ACB伴IDC患者中,IDC的ER、PR及Her2均要显著高于ACB,差异显著(P<0.05)。⑤单因素分析显示,临床病理分期、骨转移、区域淋巴结转移、远处转移及首次复发及转移均与预后不良有关;logistic多因素分析,首次复发对转移、转移率影响最大。结论ACB伴IDC比单纯的ACB、IDC的临床病理特征更显著,且预后更差。临床上及时注意患者首次复发转移时间及控制转移率可改善患者预后。Objective To investigate the clinicopathological features and prognosis of breast apocrine carcinoma(ACB)and infitrating ductal carcinoma(IDC).Methods The clinicopathological data and characteristics were retrospectively analyzed in 30 cases of ACB,30 cases of IDC and 30 cases of ACB+IDC in Liuzhou Iron and Steel Hospital and Liuzhou Worker's Hospital,and the relationship between the pathological characteristics and prognosis of the three groups was analyzed and compared.Results The average age of ACB+IDC patients was relatively old(57.23±3.51 years),which was not significantly different from that of ACB patients,and higher than that of IDC patients(50.17±5.62 years)(P<0.05).Pathological grading of ACB+IDC was mainly grades II and III,and histological grading was mainly grade II.There was significant difference between ACB and IDC and other two groups(P<0.05).The bone metastasis rate,regional lymph node metastasis rate and distant metastasis rate of ACB+IDC were 66.7%,43.3%and 46.7%respectively,higher than those of the other two groups(P<0.05).The bone metastasis rate,regional lymph node metastasis rate and distant metastasis rate of ACB+IDC were 66.7%,43.3%and 46.7%respectively,higher than those of the other two groups(P<0.05).The mean time of first metastasis and first recurrence of ACB and IDC were(12.2±2.1)months and(13.6±3.3)months respectively,which were significantly lower than those of the other two groups(P<0.05).Within 3 years,5 cases died in ACB+IDC group,the mortality rate was 16.7%,which was significantly higher than that in the other two groups,and the first time of death was thirteenth months.One case(3.3%)died in ACB and two cases(6.7%)died in IDC.The first time of death was 24 and 17 months,respectively.The mean DFS and OS cycles of ACB+IDC were(14.6±3.7)months and(23.2±2.2)months,which were significantly lower than those of the other two groups(P<0.05).The expression rates of ER,PR and HER2 in ACB+IDC were higher than those in the other two groups(P<0.05).The ER,PR and HER2 of IDC in ACB+I

关 键 词：大汗腺分化 浸润性导管癌 诊断 预后 

分 类 号：R737.9[医药卫生—肿瘤]