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肿瘤沉积物在乳腺癌患者同侧腋窝区域的预后重要性

Prognostic Importance of Tumor Deposits in the Ipsilateral Axillary Region of Breast Cancer Patients.

作者信息

Durak Merih Guray, Canda Tulay, Yilmaz Betul, Seker Nazli Sena, Kokkoz Seda Eryigit, Alicikus Zumre Arican, Akturk Nesrin, Gorken Ilknur Bilkay, Ellidokuz Hulya, Sevinc Ali Ibrahim, Saydam Serdar, Sarioglu Sulen

机构信息

Department of Pathology, Dokuz Eylul University Faculty of Medicine, Inciralti, 35340, Izmir, Turkey.

Department of Radiation Oncology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.

出版信息

Pathol Oncol Res. 2019 Apr;25(2):577-583. doi: 10.1007/s12253-018-0515-4. Epub 2018 Oct 27.

DOI:10.1007/s12253-018-0515-4
PMID:30368727
Abstract

Tumor deposits (TD) are irregular discrete tumor masses in adipose tissue, discontinuous from the primary tumor, that are described in various cancers. The incidence and/or prognostic value of TD in breast carcinomas have not been studied so far. We reevaluated 145 breast cancer patients, diagnosed and treated between 2001 and 2006 at our institution for the presence and incidence of TD. Histologic type, grade, size of the primary tumor, estrogen receptor, progesterone receptor, human epidermal growth factor receptor-2 status of the tumor, and presence of peritumoral lymphovascular invasion were included in the data. TD were detected in 42 cases (29.0%). The mean age of the patients was 52.2 years (27-82). Most patients (79.3%) had either invasive carcinoma of no special type (NST) or invasive lobular carcinoma, and most tumors (86.9%) were either grade 2 or 3. After excluding TD from the number of metastatic lymph nodes, the pN status of 9 patients changed. Univariate analysis of 110 patients with follow-up information revealed that the new pN status (p = 0.036), presence of local recurrence (p = 0.016) and TD (p = 0.003) were significantly correlated with distant metastases. The median follow-up of the patients was 84 months (5-161), 10-year disease-free survival and overall survival were 67.2% and 73.7%, respectively. In multivariate analysis, presence of TD remained independently associated with distant metastasis (p = 0.002). The probability of distant metastasis was 3.3 times higher in patients with TD. These results emphasize that TD are present in breast cancer patients, and that their presence should warn the clinician in terms of possible distant metastasis. Therefore, presence of TD, the evaluation of which is neither time consuming nor require sophisticated methods, should be included in pathology reports.

摘要

肿瘤沉积物(TD)是脂肪组织中不规则的离散肿瘤块,与原发肿瘤不连续,在多种癌症中均有描述。目前尚未对乳腺癌中TD的发生率和/或预后价值进行研究。我们重新评估了2001年至2006年在我院诊断和治疗的145例乳腺癌患者,以确定TD的存在情况和发生率。数据包括组织学类型、分级、原发肿瘤大小、雌激素受体、孕激素受体、肿瘤的人表皮生长因子受体2状态以及肿瘤周围淋巴管侵犯情况。42例(29.0%)检测到TD。患者的平均年龄为52.2岁(27 - 82岁)。大多数患者(79.3%)患有非特殊类型浸润性癌(NST)或浸润性小叶癌,大多数肿瘤(86.9%)为2级或3级。从转移淋巴结数量中排除TD后,9例患者的pN状态发生了改变。对110例有随访信息的患者进行单因素分析显示,新的pN状态(p = 0.036)、局部复发的存在(p = 0.016)和TD(p = 0.003)与远处转移显著相关。患者的中位随访时间为84个月(5 - 161个月),10年无病生存率和总生存率分别为67.2%和73.7%。在多因素分析中,TD的存在仍然与远处转移独立相关(p = 0.002)。有TD的患者发生远处转移的概率高3.3倍。这些结果强调了TD在乳腺癌患者中的存在,其存在应就可能的远处转移向临床医生发出警示。因此,TD的存在评估既不耗时也不需要复杂方法,应纳入病理报告中。

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本文引用的文献

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Tumor deposits in head and neck carcinomas.头颈部癌中的肿瘤沉积物。
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Tumor deposits in gastric carcinomas.胃癌中的肿瘤沉积物。
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Peritumoral deposits as an adverse prognostic indicator of colorectal cancer.肿瘤周围浸润作为结直肠癌不良预后的一个指标。
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Is the seventh edition of the UICC/AJCC TNM staging system reasonable for patients with tumor deposits in colorectal cancer?UICC/AJCC TNM 分期系统第七版是否适用于结直肠癌肿瘤沉积物患者?
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Lymph node negative colorectal cancers with isolated tumor deposits should be classified and treated as stage III.淋巴结阴性的结直肠癌伴孤立肿瘤细胞沉积物应归类为 III 期并进行相应治疗。
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