Zhou Wenjing, Sollie Thomas, Tot Tibor, Blomqvist Carl, Abdsaleh Shahin, Liljegren Göran, Wärnberg Fredrik
Department of Surgical Sciences, Uppsala University, Uppsala Academic Hospital, Uppsala, Sweden.
Department of Pathology, Örebro University, Örebro, Sweden.
Int J Breast Cancer. 2017;2017:4351319. doi: 10.1155/2017/4351319. Epub 2017 Feb 14.
Casting-type calcifications and a histopathological picture with cancer-filled duct-like structures have been presented as breast cancer with neoductgenesis. We correlated mammographic features and histopathological neoductgenesis with prognosis in a DCIS cohort with long follow-up. Mammographic features were classified into seven groups according to Tabár. Histopathological neoductgenesis was defined by concentration of ducts, lymphocyte infiltration, and periductal fibrosis. Endpoints were ipsilateral (IBE) in situ and invasive events. Casting-type calcifications and neoductgenesis were both related to high nuclear grade, ER- and PR-negativity, and HER2 overexpression but not to each other. Casting-type calcifications and neoductgenesis were both related to a nonsignificant lower risk of invasive IBE, HR 0.38 (0.13-1.08) and 0.82 (0.29-2.27), respectively, and the HR of an in situ IBE was 0.90 (0.41-1.95) and 1.60 (0.75-3.39), respectively. Casting-type calcifications could not be related to a worse prognosis in DCIS. We cannot explain why a more aggressive phenotype of DCIS did not correspond to a worse prognosis. Further studies on how the progression from in situ to invasive carcinoma is driven are needed.
具有铸型钙化以及充满癌细胞的导管样结构的组织病理学表现已被视为伴有新导管生成的乳腺癌。我们对一组接受长期随访的导管原位癌（DCIS）患者的乳腺钼靶特征和组织病理学新导管生成情况与预后进行了相关性分析。根据塔巴尔分类法，乳腺钼靶特征被分为七组。组织病理学新导管生成由导管密集程度、淋巴细胞浸润和导管周围纤维化来定义。观察终点为同侧原位和浸润性事件。铸型钙化和新导管生成均与高核分级、雌激素受体（ER）和孕激素受体（PR）阴性以及人表皮生长因子受体2（HER2）过表达相关，但二者之间并无关联。铸型钙化和新导管生成分别与浸润性同侧乳腺癌（IBE）较低的风险相关，但差异无统计学意义，风险比（HR）分别为0.38（0.13 - 1.08）和0.82（0.29 - 2.27），原位IBE的HR分别为0.90（0.41 - 1.95）和1.60（0.75 - 3.39）。铸型钙化与DCIS的预后较差并无关联。我们无法解释为何DCIS更具侵袭性的表型并未对应更差的预后。需要进一步研究原位癌向浸润性癌进展的驱动机制。
