不同比例乳腺浸润性微乳头状癌的临床病理特征及预后分析  

Clinicopathological features and prognosis analysis of breast invasive micropapillary carcinoma with different composition ratios

作　　者：闵丹 刘培 许诗元 喻彤 吴斌 MIN Dan;LIU Pei;XU Shiyuan;YU Tong;WU Bin(Department of Breast Surgery,The Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan 646000,P.R.China)

机构地区：[1]西南医科大学附属医院乳腺外科,四川泸州646000

出　　处：《中国普外基础与临床杂志》2024年第3期330-336,共7页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的比较不同成分比例乳腺浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)的临床病理特征,分析微乳头状癌成分占比与IMPC预后的关系。方法收集2016年8月至2020年8月期间于西南医科大学附属医院乳腺外科接受治疗的121例浸润性导管癌(invasive ductal carcinoma,IDC)合并IMPC患者的相关资料,以微乳头状癌成分占比50%为界,将患者分为IMPC<50%组和IMPC≥50%组,比较2组患者的临床病理特征,同时分析相关临床病理特征与患者预后的相关性。结果IMPC<50%组共85例,IMPC≥50%组共36例。2组患者的临床病理特征分析结果显示,2组IMPC患者在月经状态、组织学分级、分子分型、TNM分期、年龄、免疫组化表达、是否新辅助治疗、神经侵犯、乳头侵犯和皮肤侵犯方面的差异均无统计学意义(P>0.05),IMPC≥50%组的淋巴管侵犯(lymphatic vessel invasion,LVI)率为83.33%(30/36),明显高于IMPC<50%组的61.18%(52/85),2组间的差异有统计学意义(χ^(2)=5.684,P=0.017)。绘制Kaplan-Meier生存曲线,分析结果显示:IMPC患者的3年累积无病生存期(disease free survival,DFS)与淋巴结转移数目和LVI具有相关性(P<0.05),而与雌激素受体、孕激素受体、人表皮生长因子受体2、Ki-67、分子分型、微乳头状癌成分占比和组织学分级均无关(P>0.05);多因素Cox风险回归分析结果显示,淋巴结转移数目和LVI是影响患者DFS的独立预后因素。结论当IMPC成分占比≥50%时,肿瘤的LVI率较IMPC成分占比<50%者高。淋巴结转移数目和LVI是影响IMPC患者DFS的独立预后因素。Objective To compare the clinicopathological characteristics of breast invasive micropapillary carcinoma(IMPC)with different composition ratios,and analyze the relationship between proportion of micropapillary carcinoma components and the prognosis of IMPC.Methods The related data of 121 patients with invasive ductal carcinoma(IDC)complicated with IMPC who were treated in the Department of Breast Surgery,Affiliated Hospital of Southwest Medical University from August 2016 to August 2020 were collected.With micropapillary carcinoma accounting for 50%,the patients were divided into IMPC<50%group and IMPC≥50%group.The correlation between related clinicopathological features and prognosis of patients was analyzed.Results There were 85 patients in the IMPC<50%group and 36 patients in the IMPC≥50%group.The analysis results showed that there was no significant differences between the two groups in menstrual status,histological grade,molecular typing,TNM stage,age,immunohistochemical expression,neoadjuvant therapy,nerve invasion,nipple invasion,and skin invasion(P>0.05).The rate of lymphatic vessel invasion(LVI)in the IMPC≥50%group was 83.33%(30/36),which was significantly higher than 61.18%(52/85)in the IMPC<50%group,and the difference between the two groups was statistically significant(χ^(2)=5.684,P=0.017).Kaplan-Meier survival curve was drawn,and the analysis results showed that the 3-year cumulative disease-free survival(DFS)of IMPC patients was correlated with the number of lymph node metastasis and LVI(P<0.05).And with the estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2,Ki-67,molecular typing,proportion of micropapillary carcinoma components and histological grade were unrelated(P>0.05).The results of multivariate Cox risk regression analysis showed that the number of lymph node metastases and LVI were independent prognostic factors affecting DFS in patients.Conclusions When the proportion of IMPC component is≥50%,the LVI rate of tumor is higher than that of IMPC component

关 键 词：乳腺癌 浸润性微乳头状癌 临床病理特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]