乳腺神经内分泌癌回顾性分析

Retrospective analysis of neuroendocrine breast cancer

【目的】探讨乳腺神经内分泌癌（neuroendocrine breast carcinoma,NEBC）的临床诊治及预后情况。【方法】回顾分析15例乳腺神经内分泌癌的临床特征、治疗及预后,并对相关的文献进行深入性分析。【结果】15例乳腺神经内分泌癌均为女性,均以无痛性乳腺肿物就诊,影像学检查提示乳腺内不规则肿块,免疫组织化学染色结果示：神经元特异性烯醇化酶（NSE）、突触素（synaptophysin）、嗜铬素A（Cg A）阳性率较高;经以手术为主的综合治疗后,随访48~96个月（平均76个月）,复发率为33.33%（5/15）,其中1例患者出现骨转移、1例出现肺部多发转移、3例发生颈部淋巴结转移,经相关治疗后均带瘤生存,其余10例患者皆无瘤生存。【结论】影像学检查可对乳腺神经内分泌癌进行定位,病理及免疫组化检测神经内分泌指标是确诊该病的依据,综合治疗有利于提高患者的生存率,延长无病生存时间,受体阳性患者的预后与激素治疗是否存在相关性尚有待进一步研究。

【Objective】To investigate the clinical diagnosis,treatment and prognosis of neuroendocrine breast cancer（NEBC）.【Methods】Clinical features,treatment and prognosis of 15 cases（females） of NEBC were reviewed and the related literatures on the disease were retrospectively analyzed.【Results】The first symptom was palpable and painless mass of breast. Imaging inspection revealed an irregular mass in the breast. The immunohistochemical results showed that the positive rates for neuronspecific enolase（NSE）、synaptophysin and Chromogranin A（Cg A） masculine gender rate were higher than the standard level. All patients were followed up for 48 to 96 months（mean of 76 months）after the comprehensive treatment based on operation,and the recurrence rate was 33.33%（5/15）. Among the recurrence patients：1 case metastasizes to the bone, 1 case metastasizes to the lung, 3 cases metastasize to the cervical lymph node, all of them survives with tumor through the relevant treatment.The other 10 patients survived without tumor.【Conclusion】Imaging examination can be used to position NEBC,and pathological and immunohistochemical detection can be used as the basis of diagnosis. Comprehensive treatment is beneficial to improve the survival rate and prolong the disease free survival time of the patients. Whether hormone treatment is associated with the prognosis of receptor-positive patients remains to be further studied.