André S, Cunha F, Bernardo M, Meneses e Sousa J, Cortez F, Soares J
Departamento de Patologia Morfológica, Instituto Português de Oncologia de Francisco Gentil, Lisboa.
J Surg Oncol. 1995 Mar;58(3):162-7. doi: 10.1002/jso.2930580305.
A series of 82 consecutive cases of mucinous carcinomas of the female breast was investigated for their clinical, morphological, and histochemical features and for the influence of some tumor characteristics on its prognosis. Two groups, a "pure" subtype (n = 58) and a "mixed" subtype (n = 24), were considered, according to the absence or the presence of concomitant areas with typical infiltrating ductal carcinoma. Eighty patients were followed with an average of 7.4 years. The actuarial survival was 58.5% at 10 years. The group of pure mucinous carcinomas showed a statistically significant better prognosis (P = 0.0007) than that of the group of mixed tumors, as well as a lower percentage of axillary nodal metastasis. Tumor dimension of both pure and mixed mucinous carcinomas influenced the prognosis, since patients with T1 tumors had longer survival than those with T2 tumors (P = 0.05) and the latter showed less mortality than T3 tumor cases (P = 0.036). Node-negative patients also had a more favorable outcome with lower mortality than node positive patients (P = 0.007). None of the T1 pure mucinous carcinomas had axillary metastasis, which may have implications for the surgical protocols. The evaluation of quantitative and qualitative content in mucosubstances did not correlate with the prognosis. However, sulfomucins were demonstrated in 30.5% of cases; this fact points to add breast carcinoma to the group of neoplasms that may present as a metastatic sulfomucin-producing adenocarcinoma.
对82例连续的女性乳腺黏液癌病例进行了研究,分析其临床、形态学和组织化学特征,以及某些肿瘤特征对其预后的影响。根据是否存在典型浸润性导管癌的伴随区域,将病例分为两组,即“纯”亚型(n = 58)和“混合”亚型(n = 24)。80例患者接受了平均7.4年的随访。10年的精算生存率为58.5%。纯黏液癌组的预后在统计学上显著优于混合肿瘤组(P = 0.0007),腋窝淋巴结转移率也较低。纯黏液癌和混合黏液癌的肿瘤大小均影响预后,因为T1期肿瘤患者的生存期长于T2期肿瘤患者(P = 0.05),而T2期肿瘤患者的死亡率低于T3期肿瘤病例(P = 0.036)。淋巴结阴性患者的预后也比淋巴结阳性患者更有利,死亡率更低(P = 0.007)。T1期纯黏液癌均无腋窝转移,这可能对手术方案有影响。对黏液物质中定量和定性成分的评估与预后无关。然而,30.5%的病例中检测到硫酸黏液素;这一事实表明,乳腺癌应归入可能表现为转移性产生硫酸黏液素腺癌的肿瘤组。