Zhao Wei-Hong, Xu Bing-He, Zhang Pin, Li Qing, Zhao Long-Mei, Sun Yan
Department of Medical Oncology, Cancer Hospital & Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2007 Feb;29(2):137-40.
To analyze the clinicopathological features, parameters of molecular biology, survival rate, and prognostic factors in breast cancer patients with vascular invasion.
The data of 262 breast cancer patients with vascular invasion surgically treated between January 1995 and December 2003 in our institution were retrospectively analyzed. Clinicopathological characteristics, parameters of molecular biology, disease free survival rate and overall survival rate were surveyed.
Of all breast cancer patients registered in our institution during the same period, these 262 breast cancer patients with vascular invasion accounted for 5.3% with a median age of 43 years. The major pathological type was invasive ductal carcinoma (93.3%). The stages included stage I in 5% , stage II 31. 3% , stage III 58.8% , stage IV 1.1% , and unknown 3.8%. Immunohistochemical staining showed that ER positive in 67.7%, PR(+) 68.0%, p53(+) 54.2%, PCNA(+) 93.3%, c-erbB2( +++) 20.8% and c-erbB2(++) 16.9%. The 5-year and 10-year cumulative disease free survival and overall survival were 57.6% , 50.7% and 62.8%, 52.9% , respectively. The factors which were found to compromise disease free survival were the tumor size, lymph node status, stage, and radiotherapy in the univariate analysis, and for overall survival, were the tumor size, lymph node status, stage, location of vascular invasion and radiotherapy. The tumor size and radiotherapy were found to be independent prognostic factors for disease free survival and overall survival in the multivariate analysis.
Breast cancers with vascular invasion have poor biological behavior though having been treated by surgery, radiotherapy and chemotherapy. The independent prognostic factors of such patients are tumor size and radiotherapy. Anti-angiogenesis and antilymphangiogenesis may gradually become promising target treatment for such patient.
分析伴有血管侵犯的乳腺癌患者的临床病理特征、分子生物学参数、生存率及预后因素。
回顾性分析1995年1月至2003年12月在我院手术治疗的262例伴有血管侵犯的乳腺癌患者的数据。调查临床病理特征、分子生物学参数、无病生存率和总生存率。
在我院同期登记的所有乳腺癌患者中，这262例伴有血管侵犯的乳腺癌患者占5.3%，中位年龄为43岁。主要病理类型为浸润性导管癌（93.3%）。分期包括Ⅰ期5%，Ⅱ期31.3%，Ⅲ期58.8%，Ⅳ期1.1%，分期不明3.8%。免疫组化染色显示，雌激素受体（ER）阳性率为67.7%，孕激素受体（PR）阳性率为68.0%，p53阳性率为54.2%，增殖细胞核抗原（PCNA）阳性率为93.3%，c-erbB2（+++）为20.8%，c-erbB2（++）为16.9%。5年和10年累积无病生存率及总生存率分别为57.6%、50.7%和62.8%、52.9%。单因素分析中发现影响无病生存的因素为肿瘤大小、淋巴结状态、分期及放疗，影响总生存的因素为肿瘤大小、淋巴结状态、分期、血管侵犯部位及放疗。多因素分析中发现肿瘤大小及放疗是无病生存和总生存的独立预后因素。
伴有血管侵犯的乳腺癌尽管接受了手术、放疗及化疗，但其生物学行为仍较差。此类患者的独立预后因素为肿瘤大小及放疗。抗血管生成及抗淋巴管生成可能逐渐成为此类患者有前景的靶向治疗方法。
