浸润性乳腺癌合并的导管内癌成分与腋窝淋巴结转移的相关性研究

Correlation between ductal carcinoma in situ component with coexisting invasive breast carcinoma and nodal metastasis

目的探讨非特殊类型浸润性乳腺癌(IBC-NST)合并的导管内癌(DCIS)与腋窝淋巴结转移的关系。方法回顾性分析2家三甲医院初治的1647例IBC-NST临床病理特征,分析DCIS成分病理特点与腋窝淋巴结转移的关系。不含DCIS的单纯IBC-NST定义为I型。DCIS成分≤50%的IBC-NST定义为Ⅱ型。DCIS成分>50%的IBC-NST定义为Ⅲ型。结果Ⅰ型约占29.81%(491/1647);Ⅱ型比例最高,约占58.53%(964/1647);Ⅲ型约占11.66%(192/1647)。Ⅰ型IBC-NST与Ⅱ、Ⅲ型比较,淋巴结阳性率明显更高(均P<0.05)。亚组分析提示仅在浸润性成分长径(2~3)cm及HER-2阳性表达的IBC-NST中,Ⅱ型IBC-NST腋窝淋巴结阳性率明显低于Ⅰ型(均P<0.05)。结论在IBC-NST中,DCIS成分所占比例不同,临床病理特点也不同。DCIS成分的存在与更少的淋巴结转移相关,且可能被用于预测乳腺癌的预后及指导治疗。

Objective To investigate the correlation between intraductal carcinoma(DCIS)with non-specific invasive breast cancer(IBC-NST)and axillary lymph node metastasis.Methods the clinicopathological features of 1647 cases of IBC-NST treated in 2 grade A hospitals were retrospectively analyzed,and the relationship between the pathological features of DCIS components and axillary lymph node metastasis was analyzed.Pure IBC-NST without DCIS is defined as typeⅠ.DCIS component≤50%of IBC-NST is defined as typeⅡ.IBC-NST with DCIS composition>50%was defined as typeⅢ.Results Type I accounted for 29.81%(491/1647),typeⅡaccounted for 58.53%(964/1647),and typeⅢaccounted for 11.66%(192/1647).The positive rate of lymph nodes in typeⅠIBC-NST was significantly higher than that in typeⅡandⅢ(P<0.05).Subgroup analysis showed that the positive rate of typeⅡIBC-NST axillary lymph node was significantly lower than typeⅠonly in IBC-NST with infiltrating component length(2-3 cm)and positive expression of HER-2(P<0.05).Conclusion In IBC-NST,the proportion of DCIS is different,and the clinicopathological characteristics are different.The presence of DCIS components is associated with less lymph node metastasis and may be used to predict prognosis and guide treatment of breast cancer.