Shi Fengyi, Ye Haijun, Chai Z
Department of Pathology, 205th Hospital of PLA, Jinzhou 121001, China (Email:
Zhonghua Bing Li Xue Za Zhi. 2002 Jun;31(3):208-12.
To study the relationship between pathological features and classification criteria of the breast Phyllodes tumor.
203 cases of breast phyllodes tumor diagnosed in 22 hospitals since 1956 were analyzed and reappraised by a retrospective study.
133 cases were benign, 42 cases were borderline and 28 were malignant. The follow-up (6 to 372 months) showed that 28/133 benign, 19/42 borderline and 18/28 malignant cases recurred, and 17 patients (2 borderline and 15 malignant) died. The statistic cluster analysis demonstrated that stromal cellar atypia, margin involvement, mitotic activity and tumor necrosis were retained in the variable group, and no error distinguish were showed.
The breast phyllodes tumor can be classified as the following three types: benign, borderline and malignant. It is important to diagnose and classify the breast phyllodes tumor according to the involvement of tumor margin, stromal cellar atypia, mitotic activity, stromal overgrowth and tumor necrosis. There are significant differences of 5 years survival rates, recurrent rates and death rates between the benign, borderline and malignant breast phyllodes tumor. With wide excision the recurrence of the tumor decreased suggesting that broad excision is preferred for the benign phyllodes tumor and mastectomy is indicated for recurred borderline and malignant tumors.
研究乳腺叶状肿瘤的病理特征与分类标准之间的关系。
对1956年以来在22家医院诊断的203例乳腺叶状肿瘤进行回顾性研究分析及重新评估。
133例为良性，42例为交界性，28例为恶性。随访（6至372个月）显示，133例良性病例中有28例复发，42例交界性病例中有19例复发，28例恶性病例中有18例复发，17例患者（2例交界性和15例恶性）死亡。统计聚类分析表明，基质细胞异型性、边缘受累情况、核分裂活性和肿瘤坏死保留在变量组中，无错误区分。
乳腺叶状肿瘤可分为以下三种类型：良性、交界性和恶性。根据肿瘤边缘受累情况、基质细胞异型性、核分裂活性、基质过度生长和肿瘤坏死对乳腺叶状肿瘤进行诊断和分类很重要。良性、交界性和恶性乳腺叶状肿瘤的5年生存率、复发率和死亡率存在显著差异。广泛切除可降低肿瘤复发率，提示良性叶状肿瘤首选广泛切除，复发的交界性和恶性肿瘤则需行乳房切除术。
