摘要
目的乳腺化生性癌(metaplastic breast carcinoma,MBC)是一种罕见异质性原发性乳腺癌,其激素受体表达低、预后差。本研究探讨MBC患者临床病理特点,分析其临床特征及预后影响因素。方法回顾性分析2012-08-01-2017-12-31郑州大学附属肿瘤医院乳腺科收治的32例MBC女性患者临床资料并随访,精确概率法比较不同病理类型的复发率;生存期分析采用Kaplan-Meier和Log-rank法检验;生存影响因素分析采用Cox回归。结果全组32例MBC患者,中位年龄49.5岁。随访时间9~76个月,中位40个月,6年无病生存率(disease-free survival,DFS)和总生存率(overall survival,OS)分别为58.6%和86.5%。9例患者复发,其中3例死亡。单因素分析显示,肿瘤大小(χ2=6.029,P=0.034)、淋巴结是否转移(χ2=4.661,P=0.015)以及接受放疗与否(χ2=3.521,P=0.044)是影响患者DFS的关联因素。Cox回归多因素分析显示,肿瘤大小(HR=9.604,95%CI:1.404~65.677,P=0.021)是DFS独立危险因素。结论 MBC常表现为雌激素受体、孕激素受体和人表皮生长因子受体2/neu表达缺失。手术是治疗MBC的主要方法,肿瘤小预后相对较好,术后建议化疗,具有放疗指征的患者应行术后放疗,但尚需扩大样本进行验证。
OBJECTIVE Metaplastic breast carcinoma(MBC)is a rare heterogeneous group of primary breast malignancies,with low hormone receptor expression and poor outcomes.This study aimed to investigate the clinicopathological features,treatment strategy and outcome for MBC patients,to explore the clinical behavior and prognostic factors of these neoplasms.METHODS The clinical and pathological data of 32 patients with MBC treated from Aug.1 th,2012 to Dec.31 th,2017 at Henan Cancer Hospital were analyzed retrospectively.The recurrence rate of different pathological types was compared by accurate probability method,Kaplan-Meier and Log rank methods were used to analyze the survival time,and Cox regression was used to analyze the influencing factors of survival.RESULTS Thirty-two patients with metaplastic carcinoma,all female,with a median age of 49.5 years,were enrolled in this study.The follow-up time was 9-76 months,with a median of 40 months.The six-year disease-free survival(DFS)rate and overall survival(OS)rate were 58.6% and 86.5%,respectively.Nine patients recurred,and 3 of them died.Univariate analysis showed that tumor size(χ2=6.029,95%CI:1.14-25.50,P=0.034),lymph node metastasis(χ2=4.661,P=0.015)and radiotherapy(χ2=3.521,P=0.044)were important factors affecting DFS.Multivariate analysis showed that tumor size was an independent prognostic factor(HR=9.604,95%CI:1.404-65.677,P=0.021)of DFS.CONCLUSIONS MBC is a rare special subtype of breast cancers,often show lack of expression of ER,PR and HER2/neu.Surgery is the main method for the treatment of MBC.Small tumors have a relatively good prognosis.Adjuvant chemotherapy may be recommended.Radiotherapy should be a multimodality therapy component for patients with the indications,but need to expand the sample to verify.
作者
王丽娜
吴军召
黄涛
朱久俊
焦得闯
乔江华
卢振铎
刘真真
WANG Li-na;WU Jun-zhao;HUANG Tao;ZHU Jiu-jun;JIAO De-chuang;QIAO Jiang-hna;LU Zhen-duo;LIU Zhen-zhen(Department of Breast Surgery,Affiliated Cancer Hospital of Zhengzhou University,Henan Tumor Hospital,Zhengzhou 450008,P.R.China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2020年第1期58-62,70,共6页
Chinese Journal of Cancer Prevention and Treatment
关键词
乳腺化生性癌
临床病理特征
治疗
预后
影响因素
metaplastic breast carcinoma
clinicopathological features
therapy
prognosis
influence factor
