87例浸润性多病灶乳腺癌临床病理特征分析

Clinicopathological Characteristics of 87 Cases of Invasive Multifocal Breast Cancer

目的:探究浸润性多病灶乳腺癌的临床及病理特征,为治疗提供可行性建议。方法:对2018年1月-2020年10月本院收治的87例浸润性多病灶乳腺癌和220例浸润性单病灶乳腺癌患者的临床病理资料进行回顾性分析,比较两组临床病理特征的差异,并分析多病灶乳腺癌常规病理、病灶间免疫组化表达和分子分型的异质性。结果:多病灶乳腺癌和单病灶乳腺癌的腋窝淋巴结转移率分别是58.6%和44.5%,脉管侵犯率分别为32.2%和20.9%,差异均有统计学意义(P<0.05)。87例多病灶乳腺癌患者中,不同病灶间不同的病理类型和组织学分级者分别为3例(3.4%)、7例(8.0%),ER、PR、Ki-67、HER-2表达存在异质性者分别为4例(4.6%)、5例(5.7%)、6例(6.9%)、1例(1.1%)。分子分型不同者为8例(9.2%)。结论:多病灶乳腺癌较单病灶乳腺癌具有更强的侵袭性。多病灶乳腺癌不同病灶间存在组织病理学结果的异质性,这可能会影响部分患者治疗方案的制定,对所有病灶都进行免疫组化检测是有必要的。

Objective:To explore the clinical and pathological features of invasive multifocal breast cancer and provide feasible suggestions for treatment.Method:The clinicopathological data of 87 patients with invasive multifocal breast cancer and 220 patients with invasive unifocal breast cancer treated in our hospital from January 2018 to October 2020 were analyzed retrospectively.The differences of clinicopathological features between the two groups were compared,and the heterogeneity of routine pathology,immunohistochemical expression and molecular type of multifocal breast cancer were analyzed.Result:The axillary lymph node metastasis rates of multifocal breast cancer and unifocal breast cancer were 58.6%and 44.5%,respectively,and the vascular invasion rates were 32.2%and 20.9%,respectively,the differences were statistically significant(P<0.05).Among the 87 patients with multifocal breast cancer,3 cases(3.4%)and 7 cases(8%)had different pathological types and histological grades among different lesions,and 4 cases(4.6%),5 cases(5.7%),6 cases(6.9%),and 1 case(1.1%)had heterogeneous expression of ER,PR,Ki-67,and HER-2,respectively.There were 8 cases(9.2%)with different molecular types.Conclusion:Multifocal breast cancer is more aggressive than unifocal breast cancer.There is histopathological heterogeneity among different lesions of multifocal breast cancer,which may affect the treatment of some patients,so it is necessary to detect all lesions by immunohistochemistry.