Sun Bing, Huang Zhou, Wu Shikai, Ding Lijuan, Shen Ge, Cha Lei, Wang Junliang, Song Santai
Department of Radiotherapy, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China.
Department of Science and Technology, Academy of Military Medical Sciences, Beijing 100071, China.
Oncotarget. 2016 Nov 8;7(45):74006-74014. doi: 10.18632/oncotarget.12176.
Brain metastasis (BM) with a cystic component from breast cancer is rare and largely uncharacterized. The purpose of this study was to identify the characteristics of cystic BM in a large cohort of breast cancer patients.
A total of 35 eligible patients with cystic BM and 255 patients with solid BM were analyzed. Three factors were significantly associated with an increased probability of developing cystic lesions: age at diagnosis ≤ 40 years, age at BM ≤ 45 years, and poor histological grade (p < 0.05). Patients with cystic metastasis were also characterized by a larger metastasis volume, a shorter progression-free survival (PFS) following their first treatment for BM, and poor overall survival after BM (p < 0.05). Multivariate analysis further demonstrated that local control of cystic BM was only potentially achieved for HER2-negative primary tumors (p = 0.084).
Breast cancer patients with parenchymal BM were reviewed from consecutive cases treated at our institution. Cystic BM was defined when the volume of a cystic lesion was greater than 50% of the aggregated volume of all lesions present. Clinicopathologic and radiographic variables were correlated with development of cystic lesions and with prognosis of cystic BM.
This study shows that cystic BM from breast cancer, a special morphological type of BM, had worse prognosis than the more commonly observed solid BM. Younger age and low tumor grade were associated with the development of cystic lesions. Further comprehensive research and management of cystic BM are warranted to improve its poor prognosis.
来自乳腺癌的具有囊性成分的脑转移（BM）罕见且在很大程度上未被充分描述。本研究的目的是确定一大群乳腺癌患者中囊性BM的特征。
共分析了35例符合条件的囊性BM患者和255例实性BM患者。三个因素与发生囊性病变的概率增加显著相关：诊断时年龄≤40岁、发生BM时年龄≤45岁以及组织学分级差（p<0.05）。囊性转移患者还具有转移体积较大、首次治疗BM后无进展生存期（PFS）较短以及BM后总生存期较差的特点（p<0.05）。多变量分析进一步表明，仅HER2阴性原发性肿瘤的囊性BM有可能实现局部控制（p=0.084）。
回顾了在我们机构接受治疗的连续病例中患有实质性BM的乳腺癌患者。当囊性病变的体积大于所有存在病变的总体积的50%时，定义为囊性BM。临床病理和影像学变量与囊性病变的发生以及囊性BM的预后相关。
本研究表明，来自乳腺癌的囊性BM是一种特殊形态类型的BM，其预后比更常见的实性BM更差。年龄较小和肿瘤分级低与囊性病变的发生有关。有必要对囊性BM进行进一步的综合研究和管理，以改善其不良预后。
