44例男性乳腺癌的临床病理特征分析

Clinical-pathologic study of 44 patients with male breast cancer

目的分析44例男性乳腺癌(male breast cancer,MBC)的基本病理特征及临床资料,提高对MBC的认识。方法收集郑州大学第一附属医院、郑州大学第二附属医院及郑州市中心医院2002年1月至2017年5月收治的44例MBC患者的临床病理资料,分析其流行病学、临床表现、病理改变、治疗方法和预后。结果 MBC发病年龄12~82岁,中位年龄62岁,左右侧发病均22例,比例为1∶1,乳腺肿块为首要临床表现;Ⅲ、Ⅳ期患者共占47.8%;组织学类型以非特殊类型浸润性癌为主(77.6%);基因分型中56.9%为Luminal A型,Luminal B型36.2%,Basal-like型6.9%,未见HER-2过表达型。90.9%患者雌激素受体阳性,84.1%患者孕激素受体阳性;33例(75.0%)患者接受乳腺癌改良根治术。组织学Ⅱ级11例,组织学Ⅲ级3例,平均无瘤生存期分别为53.6、31.7个月;Luminal A型、Luminal B型和Basallike型的平均无瘤生存期分别为68.2、37.5、25.5个月。结论 MBC比较少见,发病年龄集中于老年人。非特殊类型浸润性癌是主要的病理类型,Luminal A型和Luminal B型是常见分子分型。组织学Ⅲ级及Basal-like型的患者预后较差,Luminal A型患者预后较好。

Objective The basic pathological features and clinical data of 44 male breast cancer were analyzed to improve the understanding of male breast cancer. Methods From January of 2002 to May of 2017,the data of epidemiology,clinical and pathological feature,treatment and prognosis of 44 male breast cancer patients were analyzed in the First Affiliafed Hospital of Zhengzhou University,the Second Affiliated Hospital of Zhenghzhou University,Zhengzhou Central Hospital. Results The patients were 12 to 82 years old,with a median age of 62. The primary clinical manifestation was a breast lump. Clinical stage Ⅲand Ⅳ accounted for 47. 8%,with invasive ductal cancer accounted for 77. 6%. Luminal A patients were accounted for 56. 9%,and 36. 2% patients were Luminal B,6. 9% patients were Basal-like. The percent of patients with estrogen receptor positive and progesterone receptor positive were 90. 9%,84. 1%,respectively. The disease-free survival time of patients with histologicⅡ and Ⅲ were 53. 6 months and 31. 7 months,respectively. The survival periods of Luminal A,Luminal B and Basal-like type were 68. 2 months,37. 5 months and 25. 5 months,respectively. Conclusion Male breast cancer is a rare type of disease,and the age is concentrated in old people. The predominant histological type of disease is invasive ductal cancer,Luminal A and Luminal B are common molecular typing. The prognosis of patients with histologic Ⅲ and Basal-like is poor. However,Luminal A patients have a better prognosis.