72例乳腺浸润性乳头状癌的临床分析

耿姗姗; 许旭; 顾林; 赵晶

doi:10.3969/j.issn.1000-8179.2011.06.014

摘要: 目的：分析乳腺浸润性乳头状癌的临床病理特征及影响腋窝淋巴结转移和预后的相关因素。方法：收集2000年4月～2008年1月天津医科大学附属肿瘤医院乳腺科收治的72例乳腺浸润性乳头状癌患者的临床病理资料，分析影响浸润性乳头状癌腋窝淋巴结转移的临床病理因素。Kaplan-Meier法计算生存率， Log-rank检验进行生存率显著性检验， Cox比例风险模型用于单因素、多因素分析，评价各因素对预后的影响。结果： 72例乳腺浸润性乳头状癌的3年、 5年生存率分别为89.7%、83.7%。肿瘤大小及病程长短与浸润性乳头状癌腋窝淋巴结的转移存在相关性。单因素生存分析显示： ER、 PR的表达状况及治疗方法的选择是影响乳腺浸润性乳头状癌预后的相关因素。Cox多因素分析则显示仅治疗方法的选择是影响预后的独立因素。结论：乳腺浸润性乳头状癌是一种多发生于绝经后妇女、预后较好的浸润性特殊型癌，其治疗方法的选择对患者的预后有重要影响，该类型乳腺癌应在个体耐受的情况下行手术联合其他治疗方法的综合治疗以提高患者的生存率。

Abstract: Clinical Analysis of 72 Cases with Invasive Papillary Carcinoma of the BreastShanshan GENG, Xu XU, Lin GU, Jing ZHAOCorrespondence to: Lin GU, E-mail: gulindr@yahoo.com.cnThe Second Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital,Key Laboratory of Breast CancerPrevention and Therapy of Educational Ministry Tianjin 300060, ChinaAbstract Objective: To investigate the clinicopathologic characteristics of invasive papillary carcinoma of the breast and analyzethe corresponding factors of axillary node metastasis and prognosis. Methods: Clinicalpathologic data of 72 cases with invasive papil-lary breast carcinoma were collected between April 2000 to January 2008. Chi- square criterion was used to analyze the correspondingfactors of axillary node metastasis. Survival rate was calculated by Kaplan-Meier method and Log-rank test was used to compare thesurvival rate. Univariate and multivariate factors for survival were analyzed by Cox proportional hazards regression model. Results:The overall 3- and 5-year survival rates were 89.7% and 83.7%, respectively. The result of Chi- square criterion showed that the axillarynode metastasis was correlated with tumor size and the course of disease. Cox univariate survival analysis revealed that the protein ex-pression of ER, PR, and the choice of treatment were the prognostic factors. However, Cox multivariate analysis found that only thechoice of treatment was an independent prognostic factor for invasive papillary carcinoma of the breast. Conclusion: Invasive papillarycarcinoma of the breast which occurred mostly among postmenopausal women is a special type of invasive breast cancer. It has a rela-tively good prognosis. Suitable choice of treatment is crucial for its good prognosis, combined use of surgery and other various treat-ments such as radiotherapy, chemotherapy and endocrine therapy is recommended to improve the survival rate.Keywords Breast cancer; Invasive papillary carcinoma; Clinicopathologic characteristic; Prognostic factor