乳腺浸润性微乳头状癌与三阴性浸润性导管癌的临床病理特征及预后差异

Clinicopathological Characteristics and Prognostic Differences Between Invasive Micropapillary Carcinoma and Triple Negative Invasive Ductal Carcinoma of the Breast

目的探讨乳腺浸润性微乳头状癌(IMPC)与三阴性浸润性导管癌(TNBC-IDC)的临床病理特征及预后差异。方法回顾性收集2013年1月至2018年1月郑州大学第一附属医院收治的71例IMPC患者的临床资料,包括患病年龄、经期状态、肿瘤大小及组织学分级、雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、Ki-67指数、淋巴管血管侵犯(LVI)、淋巴结状态、患者的复发转移及生存情况等,并与142例乳腺TNBC-IDC患者进行对比分析。结果IMPC患者的平均患病年龄和经期状态与TNBC-IDC相比,差异有统计学意义(P<0.05)。IMPC的Ki-67指数与TNBC-IDC相比,差异有统计学意义(P<0.05)。IMPC的肿瘤大小、淋巴管血管侵犯情况及淋巴结状态与TNBC-IDC相比,差异有统计学意义(P<0.05)。IMPC与TNBC-IDC患者的5 a总生存率分别为86.8%和86.6%,差异无统计学意义(P>0.05)。而IMPC和TNBC-IDC患者的5 a无病生存率分别为73.5%和83.6%,差异有统计学意义(P=0.04)。结论与TNBC-IDC相比,IMPC临床病理学特征较差,更易复发转移,但两者总生存率无差异。

Objective The aim of this study was to investigate the clinicopathological characteristics and prognostic differences between invasive micropapillary carcinoma(IMPC)and triple negative invasive ductal carcinoma(TNBC-IDC)of the breast.Methods The clinicopathological data of 71 patients with IMPC admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2018 were retrospectively collected,including age,menstrual status,tumor size and histological grade,estrogen receptor(ER),progesterone receptor(PR),human epidermal growth factor receptor-2(HER-2),Ki-67 index,lymphovascular invasion(LVI),lymph node status,recurrence,metastasis and survival of patients,and compared with 142 cases of TNBC-IDC.Results Compared with TNBC-IDC,the differences of average age and menstrual state of IMPC patients were statistically significant(P<0.05).The Ki-67 index of IMPC was significantly lower than that of TNBC-IDC(P<0.05).Compared with TNBC-IDC,IMPC had significant difference in tumor size,LVI and lymph node status(P<0.05).There was no significant difference between the 5-year overall survival rates of IMPC and TNBC-IDC(86.8%,86.6%,P>0.05),but the 5-year disease free survival rates of IMPC and TNBC-IDC had statistically difference(73.5%,83.6%,P=0.04).Conclusion Compared with TNBC-IDC,IMPC has poor clinicopathological features and is more prone to recurrence and metastasis,but there is no difference in overall survival between IMPC and TNBC-IDC.