伴有钙化的乳腺浸润性导管癌病理特征及预后分析

目的 乳腺癌已成为世界范围内女性恶性肿瘤中最常见的死因,伴有钙化的乳腺癌占乳腺癌30％～50％.探讨伴有钙化的乳腺浸润性导管癌(invasive ductal carcinoma,IDC)的临床病理特征及预后的影响因素.方法 收集2012-06-01-2013-06-30新疆医科大学附属肿瘤医院收治的初治可手术女性乳腺癌患者307例的临床病理资料和随访资料,根据乳腺X射线图像特征分为钙化组与非钙化组,回顾性分析其临床病理特征及3年无病生存率(disease-free survival,DFS).结果 钙化组在病理类型(P＜0.001)、淋巴结转移(P=0.037)、人表皮生长因子受体2(human epidermal growth fator gene-2,HER2)过表达(P=0.005),组织学分级(P=0.043)、临床分期(P=0.021)与非钙化组比较差异有统计学意义.钙化是淋巴结转移及HER2过表达的相关风险因素.钙化组淋巴结转移的风险是非钙化组的1.736倍;钙化组HER2过表达的风险是非钙化组的2.297倍.钙化组和非钙化组3年DFS分别为87.5％和94.9％.肿瘤直径(P=0.025)和淋巴结(P=0.009)是影响乳腺IDC无病生存时间的独立预后因素.结论 钙化组乳腺IDC更具有肿瘤转移性,预后较非钙化组差.

Pathological features and prognosis of invasive ductal breast carcinoma with calcification

OBJECTIVE Breast cancer is the most common leading cause of cancer mortality in woman.Mammographically visible micro-calcifcations are present in approximately 30 ％-50 ％ of nonpalpable breast malignancies.To research the clinical characteristics and prognosis of breast cancer with calcification.METHODS Clinicopathological data and follow-up date of 307 cases of invasive ductal breast cancer from June 1,2012 to June 20,2013 were analyzed restrospectively.The clinical features of breast cancer patients based on calcification clinical features and prognosis were observed.RESULTS In cal-group,pathological types(P＜0.001),lymph node status(P=0.037),HER2 expression(P=0.005),histological grade (P=0.043),and disease stage (P=0.021)were higher than that of non-cal group.Cal-group had higher risk in lymph node metastasis and HER2 overexpression.Lymph node metastasis in cal-group was 1.736-fold than that of non-cal group.HER2 overexpression in cal-group was 2.297-fold than that of non-cal group.3-DFS for tumor with calcification is 87.5％ and without calcification is 94.9％.Cox multivariate analysis revealed that tumor diameter (P=0.025),and lymph node status (P =0.009) were the independent prognostic factors affecting DFS.CONCLUSION Cal-group breast cancer has a worse prognosis than non-cal group,and it is easier to get carcinomatous metastasis.