基于人群的分析:乳腺鳞状细胞癌的临床病理特征和预后。

Clinicopathological Characteristics and Prognosis of Squamous Cell Carcinoma of the Breast: A Population-Based Analysis.

机构信息

Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Cancer Control. 2021 Jan-Dec;28:10732748211044355. doi: 10.1177/10732748211044355.

Abstract

BACKGROUND

To better understand the clinicopathological features and prognostic profiles of squamous cell carcinoma (SCC) of the breast.

METHODS

Information on breast cancer was obtained from the Surveillance, Epidemiology, and End Results database (2004-2016). Comparative analyses were carried out to investigate the heterogeneity in the clinicopathological characteristics and survival outcomes between SCC and invasive ductal carcinoma (IDC), while propensity score matching was conducted to analyze the variations among baseline characteristics. Prognostic factors for SCC of the breast were successively identified using Cox regression analysis.

RESULTS

A total of 382 SCC patients and 561477 IDC patients were identified in this study. Comparatively, the SCC cohort exhibited a higher proportion of male individuals, poor differentiation, an advanced TNM stage, an increasing percentage of triple-negative (TN) subtype, an increasing rate of organ involvement, and less access to therapeutics. The aggressive profile was consistent in the TN subgroup, with a significantly higher proportion in SCC than in IDC (25.7% vs 6.8%). Prognosis of SCC was profoundly poorer than that of IDC (mOS, 78.6 months and 121.6 months, < .0001; mBCSS 91.9 months vs 135.6 months, < .0001), of which the inferior tendency remained stable among disease stage and therapeutic options, while no difference was detected in the 2 subgroups with the TN subtype. The 2-year survival rate was 66.9% and the 5-year survival rate was 51.4%, with the risk factors being older age, bilateral disease, advanced TNM stage, bone and visceral involvement, surgical intervention, radiation treatment, and chemotherapy.

CONCLUSIONS

This study systematically analyzed the heterogeneous characteristics of SCC of the breast in comparison with IDC. Squamous cell breast cancer presented with increasing aggressive behavior and inferior prognosis. Prospective studies should focus on this subgroup and introduce individualized therapeutic protocols in clinical practice.

摘要

背景

为了更好地了解乳腺鳞状细胞癌(SCC)的临床病理特征和预后特征。

方法

从监测、流行病学和最终结果数据库(2004-2016 年)中获取乳腺癌信息。进行了对比分析,以研究 SCC 和浸润性导管癌(IDC)之间临床病理特征和生存结果的异质性,同时进行倾向评分匹配以分析基线特征的变化。使用 Cox 回归分析连续确定乳腺 SCC 的预后因素。

结果

本研究共纳入 382 例 SCC 患者和 561477 例 IDC 患者。相比之下,SCC 队列中男性比例较高,分化较差,TNM 分期较晚,三阴性(TN)亚型比例增加,器官受累比例增加,获得治疗的机会较少。在 TN 亚组中,这种侵袭性特征是一致的,SCC 中的比例明显高于 IDC(25.7%比 6.8%)。SCC 的预后明显差于 IDC(mOS,78.6 个月和 121.6 个月,<0.0001;mBCSS 91.9 个月比 135.6 个月,<0.0001),其中疾病分期和治疗选择的劣势仍然稳定,而 TN 亚型的 2 个亚组之间没有差异。2 年生存率为 66.9%,5 年生存率为 51.4%,危险因素为年龄较大、双侧疾病、较晚的 TNM 分期、骨和内脏受累、手术干预、放射治疗和化疗。

结论

本研究系统地分析了 SCC 与 IDC 相比的乳腺异质性特征。鳞状细胞乳腺癌表现出侵袭性行为增加和预后不良。前瞻性研究应关注这一亚组,并在临床实践中引入个体化治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2a1/8521731/5888ebb65e57/10.1177_10732748211044355-fig1.jpg

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