乳腺叶状肿瘤临床病理与预后分析

The Relationship between Clinical Pathological Features and Prognosis of Breast Phyllodes Tumor

目的探讨乳腺叶状肿瘤的临床病理特点与预后。方法回顾性分析2011年3月—2014年3月在该院治疗的62例乳腺叶状肿瘤患者临床病例资料,参照WHO 2003制定的组织学分类标准该研究将这些患者分为良性乳腺叶状肿瘤组39例、交界性和恶性肿瘤组23例,总结其病理特征以及预后情况。结果良性叶状肿瘤在发病时间、平均病程时长以及肿瘤直径大小等方面与交界性和恶性肿瘤疾病相比均差异有统计学意义(P<0.01);采用钼靶、彩超或冰冻病理组织切片检查对乳腺叶状肿瘤的诊断符合率较低,而术前空心针活检的诊断符合率要高;所有患者均经手术治疗,后期随访(33.3±0.6)个月发现肿瘤复发率为12.9%(8/62),平均复发时间为(11.0±1.4)个月。结论良性乳腺叶状肿瘤比恶性和交界性乳腺叶状肿瘤发病早、进展慢、浸润能力弱、恶性程度要低,乳腺叶状肿瘤的预后与病理类型、手术方式、间质生长以及核分裂等情况有关。

Objective To study and analyze the relationship between clinical pathological features and prognosis of breast phyllodes tumor. Methods Patients in the study were hospitalized for breast phyllodes tumor from March 2011 to March2014 at the First Affiliated Hospital of Putian College. The clinical data of 62 consecutive patients were reviewed and analyzed to summarize the pathological characteristics and prognosis of breast phyllodes tumor. According to the WHO histological classification standard of breast tumor published in 2003, these patients were divided into group of 39 cases benign breast phyllodes tumor and group of 23 cases borderline or malignant tumor. Results Compared with the benign leaf tumor group, time of onset, mean duration, tumor size with all of the above concerns of borderline or malignant tumor disease have significant differences（P〈0.01）. The diagnostic accuracy power of Molybdenum target, color Doppler ultrasound or frozen pathological tissue section on breast phyllodes tumor was incompetent, while preoperative diagnosis of the hollow needle biopsy was consistent with the higher diagnostic rate. All patients underwent surgical treatments, then 12.9%（8/62）tumor recurrence rate was found in the later period（33.3±0.6）months of follow-up, median relapse time was（11.0±1.4） months. Conclusion The incidence of benign breast phyllodes tumors was earlier but with proceeded slowly, weaker invasive ability and low malignancy than that of borderline or malignant tumor. The prognosis of breast phyllodes tumors were related to its pathological types, surgical methods, characteristic changes of stroma and somatic nuclear division of cells.