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目的比较乳腺浸润性微乳头状癌(IMPC)与浸润性导管癌(IDC)的临床资料,探讨IMPC的临床病理学特点、免疫组织化学染色表达、分子分型及预后(生存曲线)情况。方法回顾性分析2008年1月至2013年10月经病理检查确诊的42例IMPC患者(IMPC组)的临床资料,观察其病理及分子分型特点,抽取同期乳腺癌中的136例IDC患者(IDC组)作为对照。结果与IDC组比较,IMPC组在生育状态、乳腺良性病史、淋巴结转移、淋巴管侵犯、软组织侵犯、乳头侵犯、TNM分期、雌激素受体(ER)表达等方面比较,差异有统计学意义(P<0.05);而在民族、月经状况、肿瘤家族史、临床表现、肿瘤大小、组织学分级、孕激素受体(PR)、人类表皮生长因子受体2(HER2)、Ki67、分子分型、局部复发、远处转移、无瘤生存和总生存率方面比较,差异无统计学意义(P>0.05);单因素分析结果显示,有淋巴结转移、ER阴性和病理分期Ⅲ期的患者2年预后较差。结论既往有乳腺良性病史与未育女性中IMPC组发病危险性较高,其2年无瘤生存情况可能与淋巴结转移、ER和病理分期有关。
Objective To compare the clinicopathological features, immunohistochemical staining, molecular typing and prognosis of IMPC with invasive ductal carcinoma (IDC). Methods The clinical data of 42 IMPC patients (IMPC group) diagnosed by pathological examination from January 2008 to October 2013 were retrospectively analyzed. The pathological features and molecular typing were observed. One hundred and thirty-six IDC patients (IDC Group) as a control. Results Compared with IDC group, there were significant differences in IMPC group between fertility status, history of breast benign disease, lymph node metastasis, lymphatic invasion, soft tissue invasion, papillary invasion, TNM stage and estrogen receptor (ER) expression P <0.05). However, there were no significant differences in ethnicity, menstrual status, family history of tumor, clinical manifestations, tumor size, histological grade, PR, HER2, Ki67, (P> 0.05). The results of univariate analysis showed that the patients with lymph node metastasis, ER-negative and pathological stage Ⅲ had no significant difference (P> 0.05), local recurrence, distant metastasis, Poor prognosis. Conclusion There was a high incidence of benign breast disease and IMPC in non-fertile women. The 2-year disease-free survival may be related to lymph node metastasis, ER and pathological stage.