特殊类型乳腺癌的结外扩散的临床病理意义。
Clinico-pathological significance of extra-nodal spread in special types of breast cancer.
机构信息
Department of Pathology, Zeynep Kamil Maternity and Children's Training and Research Hospital, Istanbul 34668, Turkey.
出版信息
Cancer Biol Med. 2014 Jun;11(2):116-22. doi: 10.7497/j.issn.2095-3941.2014.02.006.
OBJECTIVE
To investigate the significance of extra-nodal spread in special histological sub-types of breast cancer and the relationship of such spread with prognostic parameters.
METHODS
A total of 303 breast cancer cases were classified according to tumor type, and each tumor group was subdivided according to age, tumor diameter, lymph node metastasis, extra-nodal spread, vein invasion in the adjacent soft tissue, distant metastasis, and immunohistochemical characteristics [estrogen receptor (ER), progesterone receptor (PR) existence, p53, c-erbB-2, and proliferative rate (Ki-67)]. The 122 cases with extra-nodal spread were clinically followed up.
RESULTS
An extra-nodal spread was observed in 40% (122 cases) of the 303 breast cancer cases. The spread most frequently presented in micro papillary carcinoma histological sub-type (40 cases, 75%), but least frequently presents in mucinous carcinoma (2 cases, 8%). Patients with extra-nodal spread had a high average number of metastatic lymph nodes (8.3) and a high distant metastasis rate (38 cases, 31%) compared with patients without extra-nodal spread.
CONCLUSION
The existence of extra-nodal spread in the examined breast cancer sub-types has predictive value in forecasting the number of metastatic lymph nodes and the disease prognosis.
目的
探讨特殊组织学亚型乳腺癌的结外扩散的意义，以及这种扩散与预后参数的关系。
方法
共对 303 例乳腺癌病例进行分类，根据肿瘤类型，对每个肿瘤组进行细分，根据年龄、肿瘤直径、淋巴结转移、结外扩散、相邻软组织静脉浸润、远处转移和免疫组织化学特征[雌激素受体（ER）、孕激素受体（PR）存在、p53、c-erbB-2 和增殖率（Ki-67）]。对 122 例有结外扩散的病例进行了临床随访。
结果
在 303 例乳腺癌病例中，有 40%（122 例）观察到结外扩散。在微乳头状癌组织学亚型中最常出现扩散（40 例，75%），而粘液癌中最不常见（2 例，8%）。与无结外扩散的患者相比，有结外扩散的患者转移淋巴结的平均数量较高（8.3 个），远处转移率较高（38 例，31%）。
结论
在检查的乳腺癌亚型中存在结外扩散对预测转移淋巴结的数量和疾病预后具有预测价值。
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