妊娠相关性乳腺癌临床病理特点及预后

Pathological features and prognosis of pregnancy-associated breast cancer

目的探讨妊娠相关性乳腺癌(PABC)的病理特征及对临床预后的影响。方法回顾性分析2009年1月至2017年12月间54例PABC患者的资料,按年龄与108例非妊娠乳腺癌对照组相匹配。比较两组患者的临床和病理特点,总生存率和无病生存率的差异。结果PABC在肿瘤大小、腋窝淋巴结转移、脉管内癌栓发生率、孕激素受体(PR)和雌激素受体(ER)阴性率较高(P<0.05)。PABC组累积总生存率和无病生存率低于对照组(P<0.05)。多因素分析显示妊娠状态、肿瘤大小、淋巴结转移、脉管内癌栓是影响乳腺癌总生存率和无病生存率的危险因素(P<0.05)。结论妊娠是影响乳腺癌患者总生存率和无病生存率预后的重要因素,进一步的研究应该探索PABC的生物学特性和病理特征,为治疗提供依据,改善预后。

Objective To investigate the pathological features of pregnancy associated breast cancer(PABC)and its influence on clinical prognosis.Methods We retrospectively analyzed the data of 54 PABC patients,and age-matched with 108 controls from January 2009 to December 2017.The clinical and pathological characteristics including the rates of(overall survival,OS)and(disease-free survival,DFS)of the patients in the two groups were compared and the factors affecting the prognosis of breast cancer were analyzed.Results PABC tumors were more advanced in tumor size,axillary lymph node involvement,carcinoma in a vessel,the negative rates of progesterone receptor(PR)and estrogen receptor(ER)(P<0.05).The OS and DFS of PABC group were lower than those in the control group(P<0.05).Multivariate analysis revealed that pregnancy status,advanced tumor size,nodal involvement,and carcinoma in a vessel were related with poor DFS and OS(P<0.05).Conclusion Pregnancy-associated status is a strong prognostic factor of OS and DFS in BC.Further studies should focus on biologic specificities and pathological features of PABC,providing evidence for the treatment and prognosis of PABC.