Zhang Wu, Huang Yuquan, Zhou Ye, Xue Jiaojiao, Gao Shan, Kang Lin, Shi Jian, Zhou Tao, Duan Yalong, Guo Sihan, Li Qingxia
Graduate School, North China University of Science and Technology, Tangshan, Hebei, China.
Guilin Medical University, Guilin, Guangxi, China.
PLoS One. 2024 Dec 23;19(12):e0300116. doi: 10.1371/journal.pone.0300116. eCollection 2024.
The difference in prognosis between invasive lobular carcinoma (ILC) and invasive ductal carcinoma (IDC) is still controversial in the academic community. Resolving this controversy can help to more accurately determine patients' prognosis, provide further personalized treatment, alleviate unnecessary psychological burden for some patients, and provide direction for further fundamental research.
A retrospective cohort study was conducted using the SEER Research Plus Data 8 Registries, Nov 2021 sub (1978-2019), including female breast cancer patients diagnosed with ILC or IDC between 2010 and 2015. Univariate and multivariate Cox regression analyses were performed, and key covariates affecting prognosis were selected. Propensity score matching (PSM) was employed to match patients, and balance tests were conducted to evaluate covariate distribution. Disease-specific survival (DSS) differences between the matched IDC and ILC groups were compared.
Following PSM, the covariate differences between the IDC and ILC groups were significantly reduced. The survival analysis revealed a significantly better prognosis for the IDC group than the ILC group (Log-rank test p < 0.001), with a 28.0% increased risk observed in the ILC group.
This study provides evidence supporting the existence of significant differences in prognosis between IDC and ILC patients after rigorous matching. The IDC group displayed a significantly better prognosis than the ILC group. Notably, these findings have implications for personalized treatment in clinical practice and contribute to the ongoing academic debate on survival differences between IDC and ILC. However, further research is needed to investigate the biological mechanisms, gene expression, and signaling pathway disparities between IDC and ILC, aiming to provide more targeted guidance for clinical decision-making.
浸润性小叶癌（ILC）和浸润性导管癌（IDC）的预后差异在学术界仍存在争议。解决这一争议有助于更准确地判断患者预后，提供进一步的个性化治疗，减轻部分患者不必要的心理负担，并为进一步的基础研究提供方向。
采用SEER Research Plus Data 8 Registries 2021年11月版（1978 - 2019年）进行回顾性队列研究，纳入2010年至2015年间诊断为ILC或IDC的女性乳腺癌患者。进行单因素和多因素Cox回归分析，选择影响预后的关键协变量。采用倾向评分匹配（PSM）对患者进行匹配，并进行平衡检验以评估协变量分布。比较匹配后的IDC组和ILC组之间的疾病特异性生存（DSS）差异。
PSM后，IDC组和ILC组之间的协变量差异显著降低。生存分析显示，IDC组的预后明显优于ILC组（对数秩检验p < 0.001），ILC组观察到风险增加28.0%。
本研究提供了证据，支持在严格匹配后IDC和ILC患者的预后存在显著差异。IDC组的预后明显优于ILC组。值得注意的是，这些发现对临床实践中的个性化治疗具有启示意义，并有助于正在进行的关于IDC和ILC生存差异的学术辩论。然而，需要进一步研究来调查IDC和ILC之间的生物学机制、基因表达和信号通路差异，旨在为临床决策提供更有针对性的指导。
