具有微乳头结构的乳腺黏液癌临床病理特征及预后研究

赵颖; 林辉; 赵洪猛; 曹旭晨

doi:10.3969/j.issn.1000-8179.2017.05.384

具有微乳头结构的乳腺黏液癌临床病理特征及预后研究

Clinicopathological characteristics and prognosis of mucinous micropapillary carcinoma

摘要

摘要:
目的探讨具有微乳头结构的乳腺黏液癌（mucinous micropapillary carcinoma，MUMPC）的临床病理特征及其对预后的影响。
方法回顾性分析天津医科大学肿瘤医院2003年9月至2008年12月192例收治且病理诊断为乳腺黏液癌（mucinous breast cancer，MBC）患者的临床病理资料。根据病理类型分为101例单纯型乳腺黏液癌（pure MBC，PMBC）及91例混合型乳腺黏液癌（mixed MBC，MMBC）。在101例PMBC中筛选出35例MUMPC作为研究组，66例无微乳头结构的PMBC作为对照组（定义为pMBC组），分析各组临床病理特征及其对预后的影响。
结果 MUMPC组淋巴结阳性、Ki-67指数表达阳性患者比例较高，与对照组比较差异具有统计学意义（P < 0.05）。MUMPC组患者总体5年无病生存率（disease free survival，DFS）为96.1%，10年DFS为68.9%。pMBC、MMBC、MUMPC组的5年DFS分别为100.0%、91.9%、100.0%，10年DFS分别为91.8%、56.2%、73.0%，三组之间比较差异具有统计学意义（P=0.011），对MUMPC预后因素行单因素分析发现，病理淋巴结分期为DFS的影响因素（P=0.006）。
结论 MUMPC的预后与pMBC相比较差，与MMBC相比较好。MUMPC患者中淋巴结分期是唯一影响预后的危险因素。对预后较差的患者，应予以更加积极的辅助治疗。

Abstract:
Objective To investigate the clinicopathological characteristics and prognosis of mucinous micropapillary carcinoma (MUMPC) of the breast.
Methods A total of 192 cases diagnosed as mucinous breast carcinoma in Tianjin Medical University Cancer Institute and Hospital between September 2003 to December 2008 were retrospectively analyzed. Patients were divided into pure mucinous breast carcinoma (PMBC, 101 cases) and mixed mucinous breast carcinoma (MMBC, 91cases). A total of 35 cases of MUMPC were selected in the PMBC group as the experimental group and cases without micropapillary structure were classified as control (pMBC) group. Clinicopathological characteristics and prognosis of MUMPC, MMBC, and pMBC were compared, and the influencing factors were recognized.
Results The rates of patients with axillary lymph node metastasis and Ki-67 labeling index positive were significantly higher in the MUMPC group than in the control group (P < 0.05). The 5-year and 10-year disease-free survival (DFS) rates of all cases were 96.1% and 68.9%, respectively. DFS significantly differed among the three groups. The 5-year DFS rates of the pMBC, MMBC, and MUMPC groups were 100%, 91.9%, and 100%, respectively. By contrast, the corresponding 10-year DFS rates were 91.8%, 56.2%, and 73.0%. N-staging was the independent prognostic factor for MUMPC (P=0.006).
Conclusion The prognosis of MUMPC was worse than pMBC, but better than MMBC. Pathological lymph node-staging was the only one prognostic factor for MUMPC. Patients with worse prognosis acquired positive treatment.

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