乳腺黏液癌48例临床病理特征及预后分析  

Clinicopathological features and prognosis of breast mucinous carcinoma: Analysis of 48 cases

作　　者：程岚卿 孔源 李恒[1,2] 张敏[1,2] 杜军 CHENG Lan-qing;KONG Yuan;LI Heng;ZHANG Min;DU Jun(Department of Pathology,the First Affiliated Hospital University of Science and Technology of China,Hefei 230036,China;Intelligent Pathology Institute,the First Affiliated HospitalUniversity of Science and Technology of China,Hefei 230036,China;Department of General Surgery,the First Affiliated HospitalUniversity of Science and Technology of China,Hefei 230036,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)临床病理中心,合肥230036 [2]中国科学技术大学智慧病理研究所,合肥230036 [3]中国科学技术大学附属第一医院(安徽省立医院)普外科,合肥230036

出　　处：《诊断病理学杂志》2024年第9期855-860,共6页Chinese Journal of Diagnostic Pathology

基　　金：安徽省高等学校科学研究项目(2023AH053414)。

摘　　要：目的 探讨乳腺黏液癌的临床病理学特征及其不同形态学亚型对预后的意义。方法 回顾性分析中国科学技术大学附属第一医院收治的48例乳腺黏液癌病例,总结分析其临床表现、组织病理学特征、免疫组化结果及预后情况。结果 48例患者均为女性,年龄33~88岁,中位年龄54岁。ER、PR在全部病例均呈弥漫强阳性表达,HER2在2例微乳头型黏液癌及1例混合型黏液癌呈3+阳性表达/扩增。微乳头型黏液癌与其他类型黏液癌相比,HER2低表达占比较多,并具有较高的核级及组织学分级(P <0.05)。Kaplan-Meier生存分析显示,黏液癌中的微乳头状结构和核级均与患者的无进展生存期(PFS)呈负相关(P <0.05)。Cox单因素分析显示,核级别是影响乳腺黏液癌患者PFS的相关因素(P <0.05)。结论 乳腺微乳头型黏液癌是一种特殊形态的黏液癌,不同于普通类型的单纯型黏液癌,具有较高的侵袭性和不良预后,应正确认识和诊断这种类型的乳腺癌。Objectives To investigate the clinical pathology of mucinous breast carcinoma(MBC)and the clinical significance of its different subtypes.Methods A retrospective analysis of 48 MBC cases admitted to the First Affiliated Hospital of the University of Science and Technology of China were performed,summarizing their clinical manifestations,histopathological characteristics,immunohistochemical results and prognosis.Results All 48 patients were female,aged 33-88 years and median age 54 years.ER and PR showed diffuse strong positive expression in all cases,and HER2 was 3+positive/amplification in 2 micropapillary mucinous carcinoma(MPMC)and one mixed type mucinous breast carcinoma(mMBC).MPMC had higher nuclear grade and histological grade with other types of MBC(P<0.05).Kaplan-Meier survival analysis showed that micropapillary structure and nuclear grade were inversely associated with progression-free survival(PFS)(P<0.05).Cox univariate analysis showed that nuclear grade was a associated factor affecting PFS in patients with MBC(P<0.05).Conclusion MPMC is a special type of breast cancer,different from the common type of simple mucinous carcinoma,with high aggressiveness and poor prognosis,and this special type of breast cancer should be correctly recognized and diagnosed.

关 键 词：乳腺肿瘤 黏液癌 微乳头 诊断 预后 

分 类 号：R737[医药卫生—肿瘤]