125例乳腺浸润性小叶癌的临床特征及预后分析

Clinical characteristics and prognosis of invasive lobular carcinoma of breast： a report 125 cases

目的 分析乳腺浸润性小叶癌的临床特征及预后情况.方法 回顾性分析1990年1月至2008年12月中山大学肿瘤防治中心收治的125例乳腺浸润性小叶癌患者的临床资料,总结其临床特征、复发及生存情况.结果 125例浸润性小叶癌患者的中位年龄45岁（27～76岁）,诊断时肿块超过3 cm者占61.6%（77/125）,51.2%（64/125）患者区域淋巴结阳性,80.8%（101/125）患者为Ⅱ期以上,89.6%（112/125）患者的激素受体阳性.中位随访58个月（11～222个月）,此时有32例出现复发及转移,18例死亡.生存分析显示,浸润性小叶癌患者的5年无病牛存率和总生存率分别为82.2%和87_3%.多因素分析显示,是否进行内分泌治疗是影响浸润性小叶癌的唯一预后因素.结论 乳腺浸润性小叶癌患者在发病中位年龄上与其他病理类型乳腺癌无明显差异,诊断时呈现肿瘤较大和淋巴结侵犯较多是该病的一个特点,激素受体阳性率高是该病的另一个特点.临床病理特征的差异没有显著影响患者预后.

Objective To analyze clinicopathologic characteristics and prognostic factors of the patients with invasive lobular carcinoma of breast. Methods Clinical data of 125 patients with invasive lobular carcinoma of breast treated at Cancer Center of Sun Yat-sen University from Jan. 1990 to Dec. 2008, were analyzed. The clinical characteristics, recurrence and survival of the patients were summarized. Results Median age of 125 patients was 45 years old （range, 27 to 76 years old）. The patients with large tumor mass （≥ 3cm）, positive local lymph node, more than Ⅱ stage and positive hormone receptor at diagnosis were 77 cases（61.6 %）, 64 cases（51.2 %）, 101 cases（80.8 %） and 112 cases（89.6 %）, respectively. The median time of follow-up was 58 months （range, 11-222 months）. Of the 125 patients, 32 had local recurrence and metastasis, and 18 died. The 5-year disease-free and overall survival rates were 82.2 % and 87.3 %, respectively. Multivariate COX regression analysis showed that whether endocrine therapy or not was only a prognostic factor of patients with invasive lobular carcinoma of breast. Conclusion There is no difference in media age of patients with invasive lobular carcinoma of breast at diagnosis from other pathologic type of breast cancer. These patients are usually with larger tumor masses, more lymph node metastasis and a higher proportion of positive hormone receptor. The prognosis of patients is not affected by clinicopathologic parameters.