乳腺叶状肿瘤诊疗现状与研究进展  

Current status and research progress of diagnosis and treatment of phyllodes tumor of the breast

作　　者：徐佳伟 黎晓星 余腾骅 孙正魁 XU Jiawei;LI Xiaoxing;YU Tenghua;SUN Zhengkui(Department of Breast Surgery,Jiangxi Cancer Hospital/Affiliated Cancer Hospital of Nanchang University,Nanchang 330029,China;Medical Department of Graduate School,Nanchang University,Nanchang 330031,China;Fuzhou Medical Collage of Nanchang University,Fuzhou,Jiangxi 344000,China)

机构地区：[1]南昌大学附属肿瘤医院/江西省肿瘤医院乳腺肿瘤外科,江西南昌330029 [2]南昌大学研究生院医学部,江西南昌330031 [3]南昌大学抚州医学院,江西抚州344000

出　　处：《中国普通外科杂志》2022年第11期1527-1534,共8页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(82160565);江西省自然科学基金资助项目(20212BAB216063);江西省卫健委普通科技计划基金资助项目(202210055);江西省科技厅应用培育计划基金资助项目(2018BBG78073)。

摘　　要：乳腺叶状肿瘤(PTB)是一种临床发病率低的乳腺肿瘤,多表现为进行性增大的无痛性肿块,易与乳腺纤维腺瘤、乳腺化生性癌等疾病混淆,术前穿刺病理较难做出精确诊断,确诊有赖于肿块完整切除后的分子病理学诊断。PTB的治疗以外科手术为主,目前公认肿瘤扩大切除确保足够的阴性切缘是标准术式。放疗可进一步降低部分交界性或恶性PTB患者局部复发风险。化疗等全身治疗相关研究甚少,临床获益有限且具有一定争议。现笔者综述国内外对PTB流行病学、临床表现、影像学诊断、病理学诊断的最新研究进展,并对临床治疗的新观点进行疏理。Phyllodes tumor of the breast(PTB)is a type of breast tumor with low clinical incidence.PTB most often manifest as a progressively enlarged painless mass and may easily be confused with other diseases,such as breast fibroadenoma,breast metaplastic carcinoma.Its accurate diagnosis is difficult to achieve by preoperative aspiration biopsy,and the definitive diagnosis is based on molecular pathology after total tumor resection.At present,surgical operation is the main method for the treatment of PTB and extended resection of the tumor for ensuring an adequate negative margin is considered to be the standard surgical procedure.Radiotherapy can further reduce the risk of local recurrence in patients with borderline and malignant PTB.Currently,Studies related to systemic treatments such as chemotherapy are scarce,and the clinical benefit is limited and controversial.Here,the authors review the latest research progress in the epidemiology,clinical presentation,diagnostic imaging,and pathology of PTB at home and abroad,and sort out different new viewpoints of clinical diagnosis and treatment.

关 键 词：乳腺肿瘤/诊断 乳腺肿瘤/治疗 叶状瘤 综述 

分 类 号：R737.9[医药卫生—肿瘤]