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本研究的目的是明确乳腺浸润性小叶癌(IL)的生物学特性及其对治疗的影响.复习1548例乳腺癌,选取其中777例分为三组:浸润性导管癌(ID)661例,IL74例,混合型42例,均为单侧乳癌.中位随访时间IL组3.08年,ID组3.39年.各组年龄分布基本相同.年龄和肿瘤大小的相关分析表明仅ID组为显著负相关.精确的病理学肿瘤测量,IL组(平均3.2cm)明显大于ID组(2.2cm),混合组居中(2.6cm).39例IL癌原始乳房摄片经专家盲法复习,所测乳腺肿瘤平均大小与其病理学大小比较,病理学肿瘤大小平均大于乳房摄片肿瘤12mm(p=0.016).三组肿瘤大小差别比较,结果提示三组乳房摄片肿瘤均被明显缩小,其差别在IL组大于另外二组.IL组淋巴结阳性率(51%)高于混合组(43%)和ID组(36%)(P=0.025).病理学检查显示,IL组肿瘤大小与淋巴结阳性数的相关性明显小于ID组和混合组.诊断时TNM分期,与另二组比较,IL组Ⅰ期少Ⅲ期多,提示T_3肿瘤较多.ER+在IL组88%,ID组72%,相差显著.各组PR阳性率无差异.手术方式:乳房切除术在IL组(60%)明显多于ID组(44%).因术中发现切缘阳性而须将计划的肿块切除改为乳房切除术者在IL组约是ID组的2.5倍,统计学相差显著.行肿块切除术标本触摸检查,假阴性率IL组(11%)显著高于ID组(1%).三组间生存率和无瘤生存率均无明显差别.
The purpose of this study was to clarify the biological characteristics of breast infiltrating lobular carcinoma (IL) and its effect on treatment. Review 1548 cases of breast cancer, select 777 cases into three groups: 661 cases of invasive ductal carcinoma (ID), IL74 cases, mixed type 42 cases, are unilateral breast cancer. The median follow-up time was 3.08 years in the IL group and 3.39 years in the ID group. The age distribution was basically the same in all groups. The correlation analysis of age and tumor size showed that only the ID group was significantly negatively correlated. Accurate pathological tumor measurement, IL group (average 3.2cm) was significantly larger than ID group (2.2cm), mixed group was centered (2.6cm). 39 cases of primary breast cancer film of IL cancer were reviewed by experts blindly, the measured breast tumor The mean size was compared with its pathological size. The pathological tumor size was larger than the breast radiography tumor 12mm (p=0.016). The differences in the tumor size between the three groups showed that the three groups of breast radiography tumors were significantly reduced, and the difference was in the IL group. More than the other two groups, the positive rate of lymph node in IL group (51%) was higher than that in mixed group (43%) and ID group (36%) (P=0.025). Pathological examination showed that the tumor size in the IL group correlated with the number of positive lymph nodes. Significantly less than the ID group and the mixed group. TNM stage at diagnosis, compared with the other two groups, the IL group I period less than III, suggesting There were more T_3 tumors. ER+ was 88% in IL group and 72% in ID group. There was no significant difference in PR positive rate between groups. Surgical method: Mastectomy was significantly more in IL group (60%) than in ID group (44%). The patient who had to remove the planned mass resection to mastectomy was found to be 2.5 times larger than the ID group in the IL group because of positive margins during surgery. The statistical difference was significant. The lumpectomy specimen touch examination, false negative rate IL group (11%) was significantly higher than the ID group (1%). There was no significant difference in survival rate and disease-free survival rate between the three groups.