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目的探讨伴有浸润性微乳头状癌(IMPC)结构乳腺癌的临床病理特征和诊断标准及其与预后相关因素的关系。方法复习1989-2001年间乳腺癌存档切片,按2003年 WHO 乳腺病理学标准诊断含有 IMPC 结构的乳腺癌100例,98例获得随访结果。结果 100例具有 IMPC 结构乳腺癌中,淋巴管侵犯率69%(69/100),淋巴结转移率84.8%(84/99);98例平均随访60.1个月。结果显示,11.2%(11/98)局部复发(术后平均存活26.4个月),38.8%(38/98)远位转移(术后平均存活36.0个月),36.7%(36/98)死于肿瘤,术后5年生存率59%,10年生存率48%;单因素及多因素生存分析均显示有肿瘤家族史及淋巴管侵犯的患者预后差,内分泌治疗可降低患者死亡的风险,单因素生存分析显示术后化疗可提高患者生存率。结论伴有 IMPC 结构的乳腺癌是一种预后极差的恶性肿瘤,无论肿瘤中 IMPC 结构比例占多少都应引起重视,预后与肿瘤家族史、淋巴管侵犯有关,内分泌治疗及个体性化疗可能是提高生存率的有效方法。
Objective To investigate the clinicopathological characteristics and diagnostic criteria of breast cancer with invasive micropapillary carcinoma (IMPC) and its relationship with prognostic factors. Methods The archives of breast cancer from 1989 to 2001 were reviewed. 100 cases of breast cancer with IMPC structure were diagnosed according to WHO Breast Pathology 2003, and 98 cases were followed up. Results 100 cases of breast cancer with IMPC lymphatic invasion rate was 69% (69/100), lymph node metastasis rate was 84.8% (84/99); 98 cases were followed up for an average of 60.1 months. The results showed that 11.2% (11/98) of local recurrence (average postoperative survival of 26.4 months), distant metastasis of 38.8% (38/98) (average postoperative survival 36.0 months), 36.7% (36/98) died In the tumor, the 5-year survival rate was 59% and the 10-year survival rate was 48%. Univariate and multivariate survival analysis showed that patients with family history of tumor and lymphatic invasion had poor prognosis. Endocrine therapy could reduce the risk of death, Univariate survival analysis showed that postoperative chemotherapy can improve the survival rate of patients. Conclusions Breast cancer with IMPC structure is a malignant tumor with poor prognosis. It should pay attention to the proportion of IMPC in tumor, prognosis is related to tumor family history and lymphatic invasion. Endocrine therapy and individual chemotherapy may be Effective ways to improve survival.