Wang Li, Zhang Wei, Lyu Shuhua, Liu Xia, Zhang Tongxian, Liu Shan, Qin Ying, Tian Xiaoqi, Niu Yun
Department of Breast Cancer Pathology and Research Laboratory, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education. Key Laboratory of Cancer Prevention and Therapy, Tianjin. Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, West Huanhu Road, Ti Yuan Bei, Hexi District, Tianjin, 300060, China.
Tumour Biol. 2015 Apr;36(4):2241-8. doi: 10.1007/s13277-014-2652-z. Epub 2015 Mar 24.
Patients with microinvasive carcinoma often have favorable prognosis, but it remains unclear whether this special type of breast cancer represents a distinct morphological entity with its own biological features and clinical behavior distinct from those of ductal carcinoma in situ (DCIS). The study is a retrospective analysis of a large patient cohort from a single institution. One hundred and thirty one microinvasive carcinoma and 451 DCIS cases were collected. ER, PR, HER2, and Ki67 were examined by immunohistochemistry in pathological sections. We assessed the clinicopathologic characteristics, molecular features, and survival status of microinvasive carcinoma and compared to those of DCIS. Microinvasive carcinoma differed from DCIS with respect to tumor size, lymph node status, and initial presentation (P < 0.05). There was a significant difference in nuclear grade among microinvasive carcinoma of different molecular subtype (P < 0.05). The clinicalpathologic features and outcomes of patients with microinvasive carcinoma were similar to those with DCIS. The 5-year OS rate for microinvasive carcinoma and DCIS patients was 99.0 and 99.2%, respectively. A combination of pathologic, clinical, and molecular factors may ultimately reveal more powerful and robust measures for disease classification than any one modality alone. Microinvasive carcinoma does not significantly predict for worse DFS or OS in comparison with patients with DCIS.
微浸润癌患者通常预后良好，但这种特殊类型的乳腺癌是否代表一种具有自身生物学特征和临床行为、不同于导管原位癌（DCIS）的独特形态学实体仍不清楚。该研究是对来自单一机构的大量患者队列进行的回顾性分析。收集了131例微浸润癌和451例DCIS病例。在病理切片中通过免疫组织化学检测雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（HER2）和Ki67。我们评估了微浸润癌的临床病理特征、分子特征和生存状况，并与DCIS进行比较。微浸润癌在肿瘤大小、淋巴结状态和初始表现方面与DCIS不同（P<0.05）。不同分子亚型的微浸润癌之间核分级存在显著差异（P<0.05）。微浸润癌患者的临床病理特征和转归与DCIS患者相似。微浸润癌和DCIS患者的5年总生存率分别为99.0%和99.2%。与单独任何一种模式相比，病理、临床和分子因素的组合最终可能揭示出更强大、更可靠的疾病分类方法。与DCIS患者相比，微浸润癌对更差的无病生存期（DFS）或总生存期（OS）并无显著预测作用。
