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伴有胃转移的乳腺癌的临床特征及预后

Clinical features and prognosis of breast cancer with gastric metastasis.

作者信息

Hong Joohyun, Kim Youjin, Cho Jangho, Lim Sung Won, Park Song Ee, Kim Hee Kyung, Lee Hansang, Cho Soo Youn, Kim Ji-Yeon, Ahn Jin Seok, Im Young-Hyuck, Park Yeon Hee

机构信息

Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.

Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.

出版信息

Oncol Lett. 2019 Feb;17(2):1833-1841. doi: 10.3892/ol.2018.9754. Epub 2018 Nov 23.

Abstract

Breast cancer rarely metastasizes to the gastrointestinal tract, including the stomach. Due to the rarity of this metastasis, it is occasionally confused with a primary stomach malignancy. However, discriminating characteristic features with clinical implications may exist. The aim of the current study was to analyze the clinical features and prognosis of breast cancer with gastric metastasis. Between January 1994 and October 2016, 13 patients at Medical Center (Seoul, Korea) were clinically or pathologically determined to have breast cancer with gastric metastasis. The present study retrospectively collected clinicopathological data from the electronic medical records of these 13 female patients. At breast cancer diagnosis, the median patient age was 45 years. A total of 7 patients (53.8%) presented with invasive lobular carcinoma (ILC) and 6 (46.2%) with invasive ductal carcinoma. Of the 13 patients, 11 were stage I-III at initial breast cancer diagnosis and underwent surgery. Positivity of breast cancer tissue samples for estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) was 92.3, 76.9 and 0%, respectively. Positivity of gastric metastasis lesions, based on immunohistochemistry results, was 81.8, 50 and 0% for ER, PR and HER2, respectively. The stomach was the location of the first metastatic lesion in 6 out of the 11 patients (54.5%) with stage I-III cancer. The median time interval from initial breast cancer diagnosis to stomach metastasis was 77.5 months. The 3-year survival rate was 79.1%, and the estimated mean survival time was 35.1 months. Breast cancer with gastric metastasis is rare, and due to this fact, a thorough pathological review and greater clinical suspicion are required in these cases.

摘要

乳腺癌很少转移至胃肠道,包括胃。由于这种转移情况罕见,它偶尔会与原发性胃恶性肿瘤相混淆。然而,可能存在具有临床意义的鉴别特征。本研究的目的是分析发生胃转移的乳腺癌的临床特征和预后。1994年1月至2016年10月期间,韩国首尔某医疗中心有13例患者经临床或病理确诊为发生胃转移的乳腺癌。本研究回顾性收集了这13例女性患者电子病历中的临床病理数据。在乳腺癌诊断时,患者的中位年龄为45岁。共有7例患者(53.8%)为浸润性小叶癌(ILC),6例(46.2%)为浸润性导管癌。在这13例患者中,11例在初次乳腺癌诊断时为I - III期并接受了手术。乳腺癌组织样本中雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER2)的阳性率分别为92.3%、76.9%和0%。基于免疫组化结果,胃转移病灶中ER、PR和HER2的阳性率分别为81.8%、50%和0%。在11例I - III期癌症患者中,有6例(54.5%)胃是首个转移病灶的部位。从初次乳腺癌诊断到胃转移的中位时间间隔为77.5个月。3年生存率为79.1%,估计平均生存时间为35.1个月。发生胃转移的乳腺癌很罕见,因此在这些病例中需要进行全面的病理检查并提高临床怀疑度。

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本文引用的文献

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Metastatic gastric cancer from breast carcinoma: A report of 78 cases.乳腺癌转移至胃癌:78例报告。
Oncol Lett. 2017 Oct;14(4):4069-4077. doi: 10.3892/ol.2017.6703. Epub 2017 Aug 2.
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World J Gastroenterol. 2014 Feb 21;20(7):1635-49. doi: 10.3748/wjg.v20.i7.1635.
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