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乳腺浸润性微乳头状癌与浸润性导管癌的预后比较:一项单中心回顾性病例对照研究

[Comparison of prognosis between invasive micropapillary carcinoma and invasive ductal carcinoma of breast: a single center, retrospective case-control study].

作者信息

Hua B, Lu X, Xiao W Z, Yang X, He S R, Wang Z

机构信息

Breast Center, Beijing Hospital, National Center of Gerontology, Beijing 100730, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2018 Jan 1;56(1):56-60. doi: 10.3760/cma.j.issn.0529-5815.2018.01.013.

Abstract

To elucidate the clinicopathological characters and prognostic factors of invasive micropapillary carcinoma of the breast (IMPC) by compared with invasive ductal carcinoma, not otherwise specified of the breast (IDC). The retrospective study was performed with female patients who had undergone curative resection for breast cancer without neoadjuvant chemotherapy from June 2008 to April 2016 in Breast Center of Beijing Hospital. Forty-seven mixed or pure IMPC patients and 93 pure IDC patients(admitted in the same center from October 2008 to January 2016 ) were matched for tumor stage, nodal status and age. Follow-up was done every 3 to 6 months postoperatively. The deadline was July 31, 2016. The curves of disease free survival and overall survival were drawn by the Kaplan-Meier method, and survival rates were compared by means of the Log-rank test. Potential prognostic variables that were identified on univariate analysis were analyzed with Cox's proportional hazards regression model for multivariate analysis. The χ(2) test or Fisher's exact test was used to compare distributions across 2 groups and the Mann-Whitney test or test was used to analyze the medians or means of 2 groups. With exact matches, the rates of lymphovascular invasion (LVI) (29.8% . 12.9%, χ(2)=5.885, =0.015)and histological grade 3 (40.4% . 21.5%, χ(2)=-2.690, =0.007) were both significantly higher in patients with IMPC than that in IDC group, but the survival between the two pathological types were not significantly different (all >0.05). The percent of IMPC component didn't influence the clinicopathologic characters (all >0.05), but a significantly longer median disease free survival (χ(2)=11.731, =0.001) when the patients had more than 50% of IMPC component was found. Higher rates of LVI and histological grade 3 were found in IMPC than that in IDC, but the survival was comparable between the two groups. A longer DFS occurred in patients with IMPC component more than 50%.

摘要

通过与乳腺非特殊类型浸润性导管癌(IDC)对比,阐明乳腺浸润性微乳头状癌(IMPC)的临床病理特征及预后因素。对2008年6月至2016年4月在北京医院乳腺中心接受乳腺癌根治性切除且未行新辅助化疗的女性患者进行回顾性研究。将47例混合性或纯IMPC患者与93例纯IDC患者(于2008年10月至2016年1月在同一中心收治)按照肿瘤分期、淋巴结状态和年龄进行匹配。术后每3至6个月进行随访。截止日期为2016年7月31日。采用Kaplan-Meier法绘制无病生存曲线和总生存曲线,并通过Log-rank检验比较生存率。对单因素分析中确定的潜在预后变量,采用Cox比例风险回归模型进行多因素分析。采用χ(2)检验或Fisher确切概率法比较两组间的分布情况,采用Mann-Whitney检验或检验分析两组的中位数或均值。经精确匹配,IMPC患者的淋巴管浸润(LVI)率(29.8% 对12.9%,χ(2)=5.885,P =0.015)和组织学3级率(40.4% 对21.5%,χ(2)= -2.690,P =0.007)均显著高于IDC组,但两种病理类型之间的生存情况无显著差异(均P>0.05)。IMPC成分百分比不影响临床病理特征(均P>0.05),但当患者IMPC成分超过50%时,无病生存期的中位数显著延长(χ(2)=11.731,P =0.001)。IMPC的LVI率和组织学3级率高于IDC,但两组间生存情况相当。IMPC成分超过50%的患者无病生存期更长。

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