Peng Li, Ma Mingwei, Zhao Dachun, Zhao Jialin, Sun Qiang, Mao Feng
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Front Oncol. 2024 May 10;14:1291034. doi: 10.3389/fonc.2024.1291034. eCollection 2024.
Neuroendocrine breast carcinoma (NECB) is a rare, special histologic type of breast cancer. There are some small sample studies on the clinical outcomes of NECB patients, which are worthy of further discussion.
We conducted a retrospective case-control study of clinical characteristics and outcomes among patients with primary NECB versus invasive carcinoma of no special type (NST) between November 2004 and November 2017 in the Peking Union Medical College Hospital, Beijing. NST patients were strictly matched 1:4 during the same period based on the TNM stage. Statistical comparisons were performed to determine the differences in survival between NST and NECB patients and to identify clinical factors that correlate with prognosis.
A total of 121 participants affected by primary NECB were included in our analysis from November 2004 to November 2017. Elderly persons (>60 years of age) were more likely to have primary NECB than young persons (p=0.001). In addition, primary NECB patients had significantly higher odds of having tumors 2-5 cm (36.5%) and >5 cm (6.1%) in size than NST patients. Despite a significant difference in tumor size, the proportion of patients with lymph node metastases showed no difference between the two groups (p=0.021). In addition, the rate of patients with ER-negative tumors in the NECB group (4.2%) was significantly lower than that in the primary NST group (29.8%). Significant differences were noted in the PR-negative (13.3% versus 36.6%, P<0.001) and HER2-negative (90.5% versus 76.4%, P=0.001) expression statuses among these patients. Of 121 primary NECB patients, 11 (9.1%) experienced relapses during the follow-up period. We found that tumor size was an independent risk factor for relapse. For hormone receptors on tumor cells, ER-positive breast cancer patients had significantly lower odds of relapse than receptor-negative patients.
Our data demonstrate no significant difference in mortality and relapse between the primary NECB and NST groups. The tumor size in the primary NECB group was significantly larger than that in the NST group. In addition, the absence of ER independently increased the relapse rate for breast carcinoma patients.
神经内分泌性乳腺癌（NECB）是一种罕见的特殊组织学类型的乳腺癌。有一些关于NECB患者临床结局的小样本研究，值得进一步探讨。
我们对2004年11月至2017年11月在北京协和医院就诊的原发性NECB患者与非特殊类型浸润性癌（NST）患者的临床特征和结局进行了一项回顾性病例对照研究。根据TNM分期，在同一时期将NST患者与原发性NECB患者按1:4严格匹配。进行统计学比较以确定NST和NECB患者生存率的差异，并确定与预后相关的临床因素。
2004年11月至2017年11月期间，共有121例原发性NECB患者纳入我们的分析。老年人（>60岁）比年轻人更易患原发性NECB（p = 0.001）。此外，原发性NECB患者肿瘤大小为2 - 5 cm（36.5%）和>5 cm（6.1%）的几率显著高于NST患者。尽管肿瘤大小存在显著差异，但两组间淋巴结转移患者的比例无差异（p = 0.021）。此外，NECB组雌激素受体（ER）阴性肿瘤患者的比例（4.2%）显著低于原发性NST组（29.8%）。这些患者中孕激素受体（PR）阴性（13.3%对36.6%，P<0.001）和人表皮生长因子受体2（HER2）阴性（90.5%对76.4%，P = 0.00）表达状态存在显著差异。121例原发性NECB患者中，11例（9.1%）在随访期间出现复发。我们发现肿瘤大小是复发的独立危险因素。对于肿瘤细胞上的激素受体，ER阳性乳腺癌患者复发几率显著低于受体阴性患者。
我们的数据表明原发性NECB组和NST组在死亡率和复发率方面无显著差异。原发性NECB组的肿瘤大小显著大于NST组。此外，ER缺失独立增加了乳腺癌患者的复发率。
