乳腺癌组织学分型探讨

Histological classification and grading of breast carcinoma

目的：探讨乳腺癌较为合理的组织学分型。方法：将２５５例乳腺癌常规石蜡切片按国内和国际标准进行病理组织学分类及分级，比较不同组织学类型和级别与预后的相关性。结果：按国内标准，将乳腺浸润性导管癌划归单纯癌（６４．３１％）、髓样癌、硬癌及腺癌，但它们的预后差异无显著性；按ＷＨＯ分类，大多数属于浸润性导管癌（７６．８６％）。原位癌、早期浸润性癌、小管癌及乳头状癌等特殊类型的癌具有独特的预后。提示乳腺癌组织学分级与预后没有明确的相关性。结论：一般的乳腺浸润性导管癌没有必要再进一步分类；某些类型的乳腺癌由于有独特的形态及预后特点，有必要划分为特殊类型。

Purpose To study the relationship between the histological classification and the prognosis of breast cancer. Methods Two hundred and fiftyfive cases of breast cancer were analysed with Chinese standard as well as WHO standard. The prognoses of different types were compared. Results The most common type was simple carcinoma (6431%) with Chinese standard, and invasive ductal carcinoma (7686%) with WHO standard. There was no significant difference among the prognoses of simple carcinoma, atypical medullary carcinoma and scirrhous carcinoma. Some forms of breast cancer had special prognostic value. There was no relationship between histological grading and prognosis. Conclusions It is unnecessary to divide the common type of invasive ductal carcinoma into subtypes. Some forms with special histological features and prognoses should be classified into special types. A new classification is proposed.