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目的分析乳腺导管内癌(DCIS)与浸润性导管癌(IDC)的相关临床病理特点。方法选取福建医科大学附属龙岩第一医院2013—2015年收治的DCIS患者40例为单纯DCIS组,另随机选取本院同期IDC患者42例为IDC组。比较两组患者年龄、临床症状、手术方式、术后病理(原发肿瘤大小、组织学分级、腋窝淋巴结转移情况及ER、PR、HER-2、Ki-67)等。结果两组患者肿物+溢血发生率比较,差异无统计学意义(P>0.05);单纯DCIS组患者肿块发生率低于IDC组,溢血发生率高于IDC组(P<0.05)。两组患者绝经情况比较,差异无统计学意义(P<0.05)。两组患者肿瘤大小比较,差异无统计学意义(P>0.05)。两组患者PR表达比较,差异无统计学意义(P>0.05);单纯DCIS组患者ER、HER-2及Ki-67表达与IDC组比较,差异有统计学意义(P<0.05)。两组患者HER-2过表达型、三阴型所占比例比较,差异无统计学意义(P>0.05);单纯DCIS组患者Luminal A型、Luminal B型与IDC组比较,差异有统计学意义(P<0.05)。结论临床医师在选择治疗方案和评估患者预后时,需综合考虑年龄、肿块特征、病理形态、淋巴结状况并结合其组织学分级、ER、PR、HER-2、Ki-67等检测结果,以便根据不同类型乳腺癌患者制定个体化综合治疗方案,从而改善患者预后。
Objective To analyze the clinicopathological features of ductal carcinoma of the breast (DCIS) and invasive ductal carcinoma (IDC). Methods Forty DCIS patients from Longyan First Affiliated Hospital of Fujian Medical University from 2013 to 2015 were selected as the pure DCIS group and 42 IDC patients randomly selected from IDC group during the same period. The age, clinical symptoms, operation methods, postoperative pathology (primary tumor size, histological grade, axillary lymph node metastasis and ER, PR, HER-2, Ki-67) were compared between the two groups. Results There was no significant difference between the two groups in the incidence of tumor and hemorrhage (P> 0.05). The incidence of tumor mass in DCIS group was lower than that in IDC group, and the incidence of hemorrhage was higher than that in IDC group (P <0.05). There was no significant difference in menopause between the two groups (P <0.05). There was no significant difference in tumor size between the two groups (P> 0.05). There was no significant difference in PR expression between the two groups (P> 0.05). The expression of ER, HER-2 and Ki-67 in DCIS group was significantly different from that in IDC group (P <0.05). There was no significant difference between the two groups in the proportion of HER-2 overexpression and tri-genotype (P> 0.05). There was significant difference between Luminal A type and Luminal B type in the DCIS group and IDC group (P <0.05). Conclusion Clinicians need to consider the age, mass characteristics, pathological features, lymph node status and combined with their histological grade, ER, PR, HER-2, Ki-67 and other test results in selecting the treatment plan and assessing the prognosis of patients, Different types of breast cancer patients to develop individualized comprehensive treatment programs to improve patient outcomes.