Yang Li-Peng, Sun He-Fen, Zhao Yang, Chen Meng-Ting, Zhang Nong, Jin Wei
Department of pathology, School of Basic Medical Sciences, Fudan University, Shanghai, 200032, China.
Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Collaborative Innovation Center of Cancer Medicine, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Cancer Med. 2017 Dec;6(12):2867-2875. doi: 10.1002/cam4.1244. Epub 2017 Nov 13.
The purpose of this study was to explore the clinicopathological features and survival outcome of pleomorphic lobular carcinoma (PLC) of breast, we identified 131 PLC patients and 460,109 invasive ductal carcinoma (IDC) patients in the Surveillance, Epidemiology, and End Result (SEER) database. PLCs presented with increased lymph node involvement, older age, higher AJCC stage and grade, and lower median survival months (PLC 84 ± 51.03 vs. IDC 105.2 ± 64.39 P < 0.01). Compared to IDC patients, PLC patients were more inclined to be treated with mastectomy. In univariate analysis, PLC patients showed a worse disease-specific survival (DSS) than that of IDC patients (hazard ratio = 0.691, 95% confidence interval 0.534-0.893, P < 0.01). In multivariate analysis, we took into account other prognostic factors and found that the histology types were no longer an independent prognostic factor (P = 0.120). DSS have no difference between matched IDC and PLC groups (P = 0.615). This result may be due to PLCs presenting higher tumor stage, higher tumor grade, and higher rate of LN metastasis than IDCs. Our conclusion is that PLC and IDC have many different characteristics, but there is not enough difference on the DSS.
本研究旨在探讨乳腺多形性小叶癌(PLC)的临床病理特征及生存结局,我们在监测、流行病学和最终结果(SEER)数据库中确定了131例PLC患者和460109例浸润性导管癌(IDC)患者。PLC表现为淋巴结受累增加、年龄较大、美国癌症联合委员会(AJCC)分期和分级较高,以及中位生存月数较低(PLC为84±51.03,而IDC为105.2±64.39,P<0.01)。与IDC患者相比,PLC患者更倾向于接受乳房切除术。单因素分析显示,PLC患者的疾病特异性生存(DSS)比IDC患者差(风险比=0.691,95%置信区间0.534-0.893,P<0.01)。多因素分析中,我们考虑了其他预后因素,发现组织学类型不再是独立的预后因素(P=0.120)。匹配的IDC组和PLC组之间的DSS无差异(P=0.615)。这一结果可能是由于PLC比IDC具有更高的肿瘤分期、更高的肿瘤分级和更高的淋巴结转移率。我们的结论是,PLC和IDC有许多不同特征,但在DSS方面差异不足。