71例黏液性乳腺癌亚分类的临床意义
Clinical significance of the sub-classification of 71 cases mucinous breast carcinoma.
作者信息
Kashiwagi Shinichiro, Onoda Naoyoshi, Asano Yuka, Noda Satoru, Kawajiri Hidemi, Takashima Tsutomu, Ohsawa Masahiko, Kitagawa Seiichi, Hirakawa Kosei
机构信息
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
出版信息
Springerplus. 2013 Sep 23;2:481. doi: 10.1186/2193-1801-2-481. eCollection 2013.
OBJECTIVE
Mucinous breast carcinoma (MBC) is classified into mixed mucinous breast carcinoma (MMBC) and pure mucinous breast carcinoma (PMBC) based on whether the tumor is with or without a component of invasive ductal carcinoma, respectively. PMBC is subtyped into hypocellular PMBC (PMBC-A) and hypercellular PMBC (PMBC-B).
METHODS
Of 1,760 primary breast carcinomas, 71 were diagnosed as MBC, and were subtyped for comparison purposes.
RESULTS
Seventy-one of all breast cancers (4.0%) were MBC, and consisted of 23 MMBC, 32 PMBC-A and 16 PMBC-B. The MBC tumors were more often hormone receptor-positive and HER2-negative than non-MBC tumors. Patients with MMBC, PMBC-B or PMBC-A, in this order, had significantly higher recurrence rates than non-MBC cases (p=0.006, log-rank).
CONCLUSIONS
In the NCCN guidelines, MBC is also regarded as "a histological type with a favorable prognosis" in a uniform manner, and "treatment for a histological type with a favorable prognosis" is recommended. However, the results of this study suggest that sub-classification-based, individualized therapeutic strategies should be considered.
目的
黏液性乳腺癌（MBC）根据肿瘤是否伴有浸润性导管癌成分分别分为混合性黏液性乳腺癌（MMBC）和纯黏液性乳腺癌（PMBC）。PMBC又分为细胞稀少型PMBC（PMBC-A）和细胞丰富型PMBC（PMBC-B）。
方法
在1760例原发性乳腺癌中，71例被诊断为MBC，并进行亚型分类以作比较。
结果
所有乳腺癌中有71例（4.0%）为MBC，包括23例MMBC、32例PMBC-A和16例PMBC-B。MBC肿瘤比非MBC肿瘤更常为激素受体阳性且HER2阴性。MMBC、PMBC-B或PMBC-A患者的复发率依次显著高于非MBC病例（p=0.006，对数秩检验）。
结论
在NCCN指南中，MBC也被统一视为“预后良好的组织学类型”，并推荐“针对预后良好的组织学类型进行治疗”。然而，本研究结果提示应考虑基于亚分类的个体化治疗策略。
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