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乳腺化生性癌。

Metaplastic carcinoma of the breast.

机构信息

Pathology Consultation Service, Clinical Trials and Practice Support Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo 104-0045, Japan.

出版信息

Hum Pathol. 2010 Jul;41(7):960-70. doi: 10.1016/j.humpath.2009.11.013. Epub 2010 Mar 17.

Abstract

The purposes of this study were to investigate whether the biological characteristics or outcomes of patients with metaplastic carcinoma, invasive ductal carcinoma, or invasive lobular carcinoma of the breast differ; to determine whether the metaplastic carcinoma subtypes have similar malignant potentials; and to identify accurate predictors of outcome in patients with metaplastic carcinoma. The subject comprised 6137 invasive ductal carcinoma patients, 301 invasive lobular carcinoma patients, and 46 metaplastic carcinoma patients of the breast. The metaplastic carcinomas were classified according to the World Health Organization classification. Multivariate analyses clearly demonstrated that the metaplastic carcinoma patients had a significantly poorer outcome than the invasive ductal carcinoma patients or the invasive lobular carcinoma patients independent of the nodal status or age not exceeding 39 years, whereas patients with triple-negative metaplastic carcinomas or triple-negative invasive lobular carcinomas had a poorer outcome than those with triple-negative invasive ductal carcinomas. Although no significant differences in clinical outcome were observed among the metaplastic carcinoma subtypes in multivariate analyses, an age not exceeding 39 years, the presence of skin invasion, and the presence of a squamous cell carcinoma component in nodal tumors were significant outcome predictors for metaplastic carcinoma patients. In conclusion, the results of this study clearly demonstrated that metaplastic carcinoma is more aggressive than invasive ductal carcinoma or invasive lobular carcinoma. Although the metaplastic carcinoma subtypes had no prognostic significance, an age not exceeding 39 years, the presence of skin invasion, and the presence of a squamous cell carcinoma component in nodal tumors were significant predictors of outcome among metaplastic carcinoma patients.

摘要

本研究旨在探讨乳腺的化生性癌、浸润性导管癌和浸润性小叶癌患者的生物学特征或结局是否存在差异;确定化生性癌的亚型是否具有相似的恶性潜能;并确定化生性癌患者结局的准确预测因素。该研究纳入了 6137 例浸润性导管癌患者、301 例浸润性小叶癌患者和 46 例乳腺化生性癌患者。化生性癌按照世界卫生组织的分类进行分类。多变量分析清楚地表明,化生性癌患者的结局明显差于浸润性导管癌患者或浸润性小叶癌患者,与淋巴结状态或年龄不超过 39 岁无关,而三阴性化生性癌或三阴性浸润性小叶癌患者的结局比三阴性浸润性导管癌患者差。尽管在多变量分析中,化生性癌的亚型之间在临床结局上没有显著差异,但年龄不超过 39 岁、存在皮肤侵犯以及淋巴结肿瘤中存在鳞状细胞癌成分是化生性癌患者结局的显著预测因素。总之,本研究结果清楚地表明化生性癌比浸润性导管癌或浸润性小叶癌更具侵袭性。尽管化生性癌的亚型没有预后意义,但年龄不超过 39 岁、存在皮肤侵犯以及淋巴结肿瘤中存在鳞状细胞癌成分是化生性癌患者结局的显著预测因素。

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