乳腺癌消化道转移病理及临床分析  

Clinicopathological analysis of gastrointestinal metastases from breast cancer

作　　者：赵园园[1] 薛登峰[2] 李鹏[2] 李静[1] Zhao Yuanyuan;Xue Dengfeng;Li Peng;Li Jing(Department of Pathology,Shanxi Cancer Hospital,Chinese Academy of Medical Sciences Shanxi Cancer Hospi-tal,Shanxi Medical University Cancer Hospital,Taiyuan 030013,China;Department of Breast Surgery,Shanxi Cancer Hospital,Chinese Academy of Medical Sciences Shanxi Cancer Hospital,Shanxi Medical University Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院病理科,太原030013 [2]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院乳腺外科,太原030013

出　　处：《实用医技杂志》2022年第11期1136-1138,I0002,共4页Journal of Practical Medical Techniques

摘　　要：目的分析乳腺癌胃肠转移的临床、病理特征及预后。方法收集山西省肿瘤医院2004年3月至2019年3月5例诊断为乳腺癌合并胃肠道转移患者的临床资料,观察其组织病理学形态及免疫组织化学结果,评估治疗及预后情况。结果5例原发乳腺癌中,3例浸润性导管癌,2例浸润性小叶癌。胃肠转移灶中,直肠2例,乙状结肠1例,小肠和直肠同时1例,小肠和胃窦同时1例,转移灶免疫组织化学表达情况与原发乳腺类型相同。4例原发乳腺癌与胃肠转移间隔时间1~14年,1例同时发现左乳肿物及子宫、结肠转移灶。5例患者1例死亡(三阴乳腺癌),1例失访(三阴乳腺癌),其余3例患者均生存。结论乳腺癌胃肠转移较为罕见,临床上容易发生漏诊及误诊。患者预后仅与原发乳腺癌的类型有关,与转移灶的部位、数目等无明显关系。且原发乳腺癌的临床分期越高,发生多部位转移的可能性越大。Objective To investigate the clinicopathological features and prognosis of gastrointestinal metastasis from breast cancer.Methods The clinical data of 5 patients diagnosed as having breast cancer and gastrointestinal metastasis in Shanxi Cancer Hospital between March 2004 and March 2019 were reviewed for pathohistological patterns,immunohistochemical test results,treatments and prognosis.Results In these 5 patients with primary breast cancer,there were 3 invasive ductal carcinomas and 2 invasive lobular carcinomas.Of the gastrointestinal metastases,2 patients had lesion in the rectum alone,1 in the sigmoid colon,1 in both the small intestine and rectum,and 1 in both the small intestine and gastric antrum.The immunohistochemical profile was identical between the metastases and type of breast cancer at the primary.The interval between the primary breast cancer and the gastrointestinal metastases ranged from 1 to 14 years in 4 patients;in the remain-ing patient,left breast mass and lesions of uterine and colon metastases were found concurrently.Of the 5 pa-tients,1 with triple-negative breast cancer deceased,1 also with triple-negative breast cancer was lost to follow-up,and the other 3 patients remained alive.Conclusion Gastrointestinal metastases from breast cancer are rare and prone to missed and mis-diagnosis in clinical practice.The prognosis of patients is related merely to the pathological type of primary breast cancer,but not to the site and number of metastases.In addition,primary breast cancer with higher clinical staging is more likely to be associated with multiple metastases.

关 键 词：乳腺肿瘤 肿瘤转移 胃肠道 

分 类 号：R737.9[医药卫生—肿瘤]