不同分子分型乳腺癌临床病理特征及预后分期分析

目的探讨不同分子分型乳腺癌的临床病理特征及预后分期系统对其分期评价的意义。方法选取236例乳腺癌病人,参照2017年版中国抗癌协会乳腺癌诊治指南与规范进行分子分型,对不同分子分型乳腺癌病人的临床病理特征进行分析,并且根据第8版美国癌症联合委员会(AJCC)乳腺癌分期标准重新评价不同分子亚型解剖分期及预后分期,比较每一种分子亚型乳腺癌中不同解剖学分期下预后分期变化的特点。结果不同分子分型乳腺癌病人之间组织学分级、Ki-67表达、淋巴结转移、解剖学分期及预后分期差异有统计学意义(P0.05),而肿瘤大小差异无统计学意义(P0.05);预后分期与解剖学分期比较发生变化,各分子亚型间变化特点差异具有统计学意义(P0.05),不同分子亚型乳腺癌中各解剖学分期的预后分期变化差异有统计学意义(P0.05)。结论不同分子亚型乳腺癌之间具有异质性,与解剖学分期相比,不同分子亚型预后分期变化特点不同,分子分型结合预后分期可为乳腺癌精准个体化治疗方案提供临床依据。     

AJCC 8~(th)解剖学及预后分期系统用于TNBC生存获益价值评估

目的探讨AJCC 8~(th)解剖学及预后分期系统用于三阴性乳腺癌(triple negative breast cancer, TNBC)生存获益的价值评估。方法回顾性分析我院2010年1月至2015年12月收治的147例TNBC患者的临床资料,比较不同解剖学及预后分期生存获益情况,评价AJCC 8~(th)解剖学和预后分期的差异。结果入选患者随访5年无进展生存(progression free survival, PFS)率和总生存(overall survival, OS)率分别为84.72%和84%;不同解剖学分期患者PFS率(除外Ⅳ期)和OS率比较差异有统计学意义(P0.05);不同预后分期患者PFS率和OS率比较差异有统计学意义(P0.05);147例患者中AJCC 8~(th)解剖学和预后分期变化者共135例(91.84%),与解剖学分期相比预后分期均提高;AJCC 8~(th)预后分期较解剖分期升高的患者各组PFS率和OS率比较差异有统计学意义(P0.05)。结论 AJCC 8~(th)预后分期系统用于TNBC预后评估可有效补充解剖学分期的不足,为临床决策的制定提供更多参考。     

转录因子E2F-4的表达与乳腺癌分级、分期及预后的关系

目的:探讨乳腺癌中转录因子E2F-4的表达与临床分期、病理组织学分级及其预后等参数的关系.方法:采用免疫组化学的方法检测乳腺癌组织中E2F-4的表达,半定量分析E2F-4的表达与肿瘤分期、分级、术后生存时间等临床病理学参数的关系:以正常乳腺组织作为对照.结果:正常乳腺小叶及导管上皮细胞之E2F-4表达呈阴性;65例乳腺癌中33例(50.8%)呈E2F-4高表达;E2F-4高表达与乳腺癌的病理学分级、类型、临床分期以及术后生存时间有关(P<0.05).结论:E2F-4作为肿瘤的相关基因,参与了乳腺癌的发生、发展.E2F-4的高表达可能是评判乳腺癌恶性程度、转移、复发及预后的较好指标.     

IL-17在乳腺癌组织中的表达及其意义

分析IL-17在乳腺癌和乳腺良性肿瘤中的表达及意义。回顾性分析山东省立医院集团东营医院普外科2010年7月—2013年9月进行手术治疗的乳腺癌患者和乳腺良性肿瘤患者,采用免疫组织化学的方法,分析IL-17在病理标本中的表达差异。IL-17在乳腺癌组织中的阳性表达率53.17%,明显高于乳腺良性肿瘤(17.31%),差异具有统计学意义(P0.01)。乳腺癌患者126例,其中,浸润性导管癌59例,IL-17阳性细胞数为15.42±5.03,阳性患者33例;浸润性小叶癌49例,IL-17阳性细胞数为15.41±5.18,阳性患者24例;乳头状癌18例,IL-17阳性细胞数为16.83±5.31,阳性患者10例;乳腺良性肿瘤104例,IL-17阳性细胞数为7.37±5.64,阳性患者18例。IL-17在乳腺癌组织中的表达与临床分期、组织学类型、病理分级和淋巴转移等因素不相关(P0.05)。     

美国癌症联合委员会肝癌分期系统(第8版)更新解读

美国癌症联合委员会(AJCC)第8版癌症分期系统已经出版并将在全球应用。新版AJCC癌症分期系统首次建立了AJCC证据等级量化标准,使得新版内容的更新有了科学客观的参考依据。AJCC第8版肝癌分期系统主要更新了原发肿瘤(T)的定义,增加了肿瘤的组织学分级,对肿瘤的影像学和病理学描述都有了明确的规定,又将评价肝功能的指标和AFP作为肝癌的预后指标。     

乳腺癌中HER-2基因的扩增及意义

目的 研究乳腺浸润性导管癌HER-2基因的扩增情况及其与乳腺癌临床病理因素的关系。方法 采用荧光原位杂交法（FISH）检测254例乳腺浸润性导管癌组织中HER-2基因的扩增情况,分析其与乳腺癌的肿瘤大小、组织学分级、腋淋巴结转移情况、病理分期、雌、孕激素受体表达以及该基因蛋白表达等的关系。结果 FISH检测到254例乳腺癌中有175例发生HER-2基因高扩增,该基因高扩增与乳腺癌的肿瘤大小、组织学分级、病理分期、腋淋巴结转移数、雌孕激素受体表达、HER-2蛋白表达均有关（P均＜0.05）,与患者的年龄无关 (P＞0.05)。结论 乳腺癌中HER-2基因的高扩增导致其蛋白过度表达,HER-2基因高扩增与乳腺癌的生长、恶性程度有关,是判断乳腺癌生物学行为的重要指标。联合检测HER-2基因扩增情况及其他指标有助于指导临床判断乳腺癌预后并制定治疗方案。     

CXCR4在乳腺癌中的表达及意义

目的：研究CXCR4在人乳腺癌及癌前病变中的表达情况,并分析其与乳腺癌相关临床病理指标之间的关系。方法：采用免疫组织化学方法（IHC）研究CXCR4在23例乳腺导管上皮增生,26例重度不典型导管上皮增生,34例乳腺导管内癌（DCIS）和126例浸润性乳腺癌组织中的表达差异情况;分析浸润性乳腺癌中CXCR4表达与腋窝淋巴结受累数目、临床分期、肿瘤直径、组织学分级等临床病理指标的相关性。结果：CXCR4在乳腺导管上皮增生、重度不典型导管上皮增生、乳腺导管内癌、浸润性乳腺癌组织中的阳性表达率依次为8.70%、23.08%、56.25%、60.32%,表达水平呈现增高趋势,具有随病变恶性程度加重而逐步增高的趋势（P〈0.05）;但导管内癌和浸润性乳腺癌两组表达水平无明显差别。CXCR4在浸润性乳腺癌中的表达与腋窝淋巴结受累数目、临床分期呈正相关,与肿瘤直径、组织学分级无明显相关性。淋巴结阳性组浸润性乳腺癌CX-CR4阳性表达率高于淋巴结阴性组（P〈0.05）。结论：CXCR4可能是乳腺癌发生的早期分子事件;CXCR4在浸润性乳腺癌中的表达与乳腺癌进展的临床病理指标相关,可作为乳腺癌的诊断指标;CXCR4可能成为乳腺癌治疗的新靶点。     

乳腺浸润性小叶癌的诊断与治疗现状

乳腺浸润性小叶癌以癌细胞突破乳腺小叶内末梢乳管或腺泡基底膜而向小叶间质浸润性生长为主要特点。患者诊断时通常具有如下特点:年龄和肿瘤较大,腋窝淋巴结转移率较高,健侧容易发生。乳腺浸润性小叶癌通常具有较好的预后表型,低级别的组织学分级,较低的有丝分裂指数。浸润性小叶癌具有较高的侵袭性和广泛转移增殖倾向,与其它浸润性癌比较,预后较差。     

癌基因iASPP在乳腺浸润性小叶癌中的表达及其意义

目的探讨p5 3凋亡刺激蛋白基因(ASPP)的抑制蛋白iASPP在乳腺浸润性小叶癌中的表达及其临床意义。方法采用RT-PCR技术扩增乳腺浸润性小叶癌组织中iASPP mRNA;同时应用Quality One软件分析iASPP扩增产物的相对含量,分析iASPP-mRNA与临床病理因素之间的关系。结果 3 9例浸润性小叶癌组织中有3 4例表达iASPP(8 7.2%),5例不表达(1 2.8%);癌旁组织中均不表达iASPP。iASPP-mRNA在乳腺浸润性小叶癌中的表达明显增高,与癌旁组织相比差异具有显著性(P0.0 1)。不同的年龄组iASPP-mRNA的表达差异也有显著性;TNMⅢ、Ⅳ期乳腺癌组织中iASPP-mRNA的表达显著高于Ⅰ、Ⅱ期患者(P0.0 1);有淋巴结转移的癌组织中iASPP-mRNA的表达也高于无淋巴结转移者;iASPP-mRNA的表达与雌、孕激素受体的表达无关。结论 iASPP-mRNA在乳腺浸润性小叶癌中高表达。检测iASPP可以为乳腺癌的诊断、个体化治疗及预后提供参考。     

胃癌AJCC分期第6版与第7版的差异及其对预后评估的分析与比较

目的 比较胃癌美国癌症联合会（AJCC）分期第6版与第7版的差异,分析、评价新的胃癌TNM分期方法的临床应用价值。方法 回顾性分析1995年9月至2007年12月在北京大学临床肿瘤学院接受治疗并具有完整临床病理资料的922例胃癌病人,比较其根据AJCC新旧两版标准分期后的预后情况。结果 胃癌第7版AJCC分期在T、N分期方面均进行了比较明显的调整,与第6版相比分期标准更为精细化,第7版分期标准对N分期进行的调整可以更好地对不同预后的病人进行区分,COX模型分析表明M分期、新版N分期、旧版TNM分期以及淋巴结清扫是否充分是反映胃癌预后最主要的独立因素。结论 与第6版分期相比,第7版的T分期、N分期标准更为合理,但新版的TNM综合分期标准对于预后评估却并未体现出优势,其具体临床价值仍有待探索。     

Prognostic impact of the 8th edition of American Joint Committee on Cancer (AJCC) cancer staging system on clinically negative lymph nodes (cN0) breast cancer patients

In 2017, the 8th edition of American Joint Committee on Cancer (AJCC) Staging Manual released the updating of TNM. The new edition introduces changes concerning tumor classification that could have a real innovative and useful clinical impact. The purpose of the study is to compare anatomic vs. prognostic stage group introduced in the new edition of AJCC staging system and its importance in clinical practice. We retrospectively analyzed the prognostic stage group introduced by the 8th edition of the AJCC staging system for breast cancer. We restaged a large series of patients with infiltrative breast cancer from 2004 to 2017 applying the AJCC 8th Edition prognostic stage group criteria. This study included 1575 patients with all molecular subtypes of breast cancer. Our follow‐up included disease‐free survival (DFS), disease‐related survival (DRS), and overall survival (OS) data. Kaplan–Meier test was used for statistical analysis. The median follow‐up was 7 years. The 5‐year and 10‐year OS were 96% and 90%, respectively. From our analysis, according to the 8th edition, the majority of patients included in the cohort had a down‐staging to a better prognostic group except the triple‐negative tumors. Most of the anatomic stage IIA turned into IA and IB. This new staging system seems to better relate to prognosis. Therefore, the prognostic stage represents an important support in breast cancer management since it could avoid unnecessary and ineffective therapies; in contrast, it could help realize the global evaluation of the risk of relapse/response to specific treatments, leading to a significant reduction in the national health cost.     

Evaluation of the 8th edition of the American joint committee on cancer’s pathological staging system in prognosis assessment and treatment decision making for stage T1-2N1 breast cancer after mastectomy

PurposeThe 8th edition of the American Joint Committee on Cancer (AJCC) pathological staging system for breast cancer considers biologic factors in addition to the anatomical features included in the previous systems. The purpose of this study was to determine the validity of the 8th AJCC staging system for T1-2N1 breast cancer and to assess the effect of additional chemotherapy and radiotherapy according to the new pathologic stages.MethodsThe cohort included patients from the Surveillance, Epidemiology, and End Results program (2010–2012) who had stage T1-2N1 invasive breast carcinoma and underwent mastectomy. All patients were restaged using the 8th AJCC staging system. The Kaplan–Meier method, Cox proportional hazards regression, and competing risks models were used for data analysis.ResultsWe identified 9908 patients including 3022 (30.5%), 3131 (31.6%), 1940 (19.6%), 1194 (12.1%), and 621 (6.3%) were classified with stage IA, IB, IIA, IIB, and IIIA disease, respectively. The 5-year breast cancer-specific survival (BCSS) was 97.3%, 94.3%, 88.3%, 84.0%, and 71.1% for stage IA, IB, IIA, IIB, and IIIA disease, respectively. Higher pathological stage was associated with a significantly higher risk of breast cancer-related death. Chemotherapy was associated with better BCSS regardless of the pathological stage, but radiotherapy was only associated with better BCSS in stage IIIA disease.ConclusionsThe 8th AJCC pathological staging system provides more refined stratification for T1-2N1 breast cancer patients after mastectomy and may meet the needs of the current trend of individualized decision making for chemotherapy and radiotherapy in this patient subset.     

The assessment of 8th edition AJCC prognostic staging system and a simplified staging system for breast cancer: The analytic results from the SEER database

The prognostic value of the prognostic staging system that incorporated estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor‐2 (Her‐2), and histological grade has been validated in breast cancer (BC) patients, but the staging system seems to be somewhat complex. Recently, an updated bioscore system based on these tumor biological factors was proposed. The purpose of this study was to compare the prognostic stratification between prognostic staging system of American Joint Commission on Cancer (AJCC) and a simplified staging system based on the bioscore system and anatomic TNM staging for BC patients. A total of 44 593 patients with invasive ductal carcinoma who underwent radical resection between 2010 and 2011 were reviewed using the SEER database. The patients were reclassified into different groups according to the anatomic staging system, prognostic staging system, risk bioscore system, and simplified staging system, respectively. The prognostic differences between different groups were compared and clinicopathologic features were analyzed. The anatomic TNM staging failed to clearly distinguish the prognostic difference between stage IIIB and stage IIIC. Therefore, we proposed an adjusted anatomic staging, in which T1N3 and T2N3 were downstaged from stage IIIC to stage IIIB, and T4N2 was upstaged from stage IIIB to stage IIIC. Histological grade III, ER(?), PR(?), and Her‐2(?) were identified as independent prognostic factors in the multivariate analysis, and these factors were separately marked as 1 point. There were significant survival differences among different risk points except for the comparison between 0 and 1 point. The higher the risk points, the poorer the prognosis of BC patients. In addition, the curve distance between stage IIA and stage IIB was not significantly broaden according to the prognostic staging system. However, the prognostic stratification for BC patients could be significantly improved by the simplified staging system incorporated the bioscore system and adjusted anatomic staging. Several drawbacks may still exist in the prognostic staging system of AJCC. A simplified staging system that incorporated risk score system and the anatomic staging could provide more accurate prognostic information for BC patients.     

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??Updates and interpretations of the 8th edition of AJCC cancer staging system for biliary tract carcinoma TANG Zhao-hui*, TIAN Xiao-dong, WEI Miao-yan, et al.*Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Corresponding author: TANG Zhao-hui, E-mail: tangzhaohui@xinhuamed.com.cn
Abstract The AJCC Cancer Staging system is an important foundation of identifying tumor staging??deciding individualized treatment option??predicting the prognosis and comparing the effectiveness of treatment. The AJCC 8th edition will become the new global guideline for cancer diagnosis and treatment from January 1, 2018. This edition cites the AJCC Levels of Evidence for the first time, which guide physicians to understand stage system more accurately. In the staging system for biliary tract (intrahepatic bile duct, gallbladder, perihilar bile ducts, distal bile duct and ampulla of Vater) carcinoma, the updates of 8th edition placing particular emphases on precise definition of primary tumor (T) and regional lymph nodes (N) , practicability and repeatability of clinical practice, application of objective indicators and prognostic evaluation based on stage. We interpret the new staging system and make further discussion about the updates.     

T-钙黏蛋白在乳腺癌中表达及其与预后关系

目的：探讨乳腺癌患者T-钙黏蛋白表达情况与乳腺癌预后相关性。方法乳腺浸润性癌（浸润性小叶癌除外）患者280例,根据T-钙黏蛋白表达分为T-钙黏蛋白表达阴性组与阳性组,分析T-钙黏蛋白在乳腺癌中表达情况与患者不同临床、病理特点及其预后。统计学分析应用SPSS 13．0软件,计数资料采用χ2检验以及Fisher精确概率法,采用Log Rank法检测乳腺癌中T-钙黏蛋白表达情况对乳腺癌5年生存率以及5年无瘤生存率的影响, P ＜0．05为差异有统计学意义。结果 T-钙黏蛋白表达阴性组与阳性组中,年龄、肿瘤直径、病理分级、病理类型、有无绝经、有无家族史等,差异均无统计学意义（P＞0．05）。 T-钙黏蛋白表达阴性组发生淋巴结转移、淋巴管浸润及临床分期Ⅲ期比例（65．2％、37．5％、23．2％）高于 T-钙黏蛋白阳性组（41．1％、13．1％、6．0％）,χ2＝15．62、22．70、17．87, P＜0．05,差异有统计学意义,T-钙黏蛋白阴性患者较T-钙黏蛋白阳性患者术后生存率及无瘤生存率均低（Log Rank＝13．629,P＜0．01;Log Rank＝22．362,P＜0．01）,差异有统计学意义。结论 T-钙黏蛋白表达与乳腺癌多种临床病理特点有相关性,T-钙黏蛋白表达阴性患者预后差。     

Prognostic factors in invasive lobular carcinoma of the breast: a multivariate analysis. A multicentre study after seventeen years of follow-up

BACKGROUND AND GOALS: The purpose of this study was to characterize the biologic determinants that affect the behavior of invasive lobular carcinoma of the breast. MATERIAL AND METHODS: A prospectively accrued data base containing 9,619 breast cancer cases was queried for specific pathological features. From this data base, 390 patients with invasive lobular carcinoma of the breast treated and followed at any of these three centers: San Carlos Hospital, Doce de Octubre Hospital or The Jimenez Diaz Foundation in Madrid (Spain) were reviewed and results, in terms of overall survival and disease-free survival were recorded for a long-term follow-up of 206 months (17 years). RESULTS: The parameters that showed an important statistical influence on survival were the stage at diagnosis, the tumor size and nodal status, as well as the tumor grade. Age showed a limited influence, and multicentricity, or the type of surgical procedure had no statistical impact on survival. CONCLUSIONS: Our analysis specifies the clinico-pathological features that influence the prognosis of invasive lobular carcinoma of the breast, and confirms that conservative therapy may be an appropriate treatment for this type of cancer.     

第8版国际抗癌联盟和美国癌症联合委员会胃癌TNM分期系统简介及解读

目前胃癌的TNM分期已经成为临床胃癌诊疗的首选参考依据。在国际抗癌联盟(UICC)、国际胃癌协会(IGCA)和美国癌症联合委员会(AJCC)的共同协作推动下,通过对全世界范围内胃癌大数据的收集与分析,于2016年10月颁布了第8版胃癌TNM分期系统。第8版TNM分期系统对食管-胃结合部及贲门癌分期标准的选择做出了明确的定义;同时还在单一分期系统的基础上新增了临床TNM分期(cTNM)和新辅助治疗后分期(ypTNM)。此外,新版的分期系统将N3的两个亚组N3a和N3b作为独立组别纳入到分期系统,还对组织学分级进行了一些调整。总的来说,相比第7版胃癌TNM分期系统,新版的分期系统可以指导临床医生更加合理地制定治疗方案,更加科学地评价治疗效果,更加准确地评估预后。然而,随着临床广泛应用和进一步验证,以及新的预测因子的发现,必将会有新的分期系统替代和完善旧的分期系统。     

Updates in the Eighth Edition of the Tumor-Node-Metastasis Staging Classification for Urologic Cancers

The Tumor-Node-Metastasis (TNM) classification on cancer staging, jointly developed by the American Joint Commission on Cancer (AJCC) and the Union for International Cancer Control (UICC), has been updated to its 8th edition with two contemporaneous versions published by the AJCC and UICC. While the goal of the AJCC and UICC is to have identical TNM staging systems, differences exist between these two publications including in the staging of urologic cancers. Among several new facets in the AJCC staging manual, a select few of greater import include an expanded section on imaging, presentation of levels of evidence for significant changes, and endorsement of risk assessment models that pass the AJCC quality criteria such as in prostate cancer. The updates for urologic cancers in the AJCC stage categories can be grouped into: (1) newly defined TNM categories and prognostic stage groupings, (2) clarifications and refinements of previously defined categories, and (3) more systematic and expanded presentation of prognostic factors. Changes are harmonized with the current reporting and treatment guidelines. Contributions from genitourinary pathology are evident in the AJCC classification from many of the International Society of Urological Pathology (ISUP) consensus conferences on prostate, kidney, testicular, and penile neoplasms that addressed staging issues and the timely publication of the 4th edition of the World Health Organization (WHO) classification of urinary and male genital organ tumors. New grading approaches for penile (WHO/ISUP grade), prostate (Grade group), and kidney (WHO/ISUP nucleolar grade) cancers were adopted in the AJCC system. Many of these updates in the AJCC staging manual are also included in the 8th UICC TNM edition. In an effort to achieve the optimal staging recommendations for urologic cancers, updates in the 8th TNM edition were generated through the acquisition of best evidences, tapping interdisciplinary resources including consensus recommendations, and enhanced data analysis.

不同分期方法在胆囊癌疗效评估中的价值

目的 探讨不同分期方法对胆囊癌疗效的评估价值.方法 回顾性分析1992年10月至2006年12月上海交通大学附属新华医院手术治疗的132例胆囊癌患者的临床资料,按照胆囊癌Nevin分期、AJCC第5版分期、AJCC第6版分期方法统计各患者的临床分期及各期胆囊癌的术后生存率.生存分析采用Kaplan-Meier法,组间比较采用Log-rank检验.结果 按照Nevin分期统计的Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ期的累积生存率分别为80.3%、75.6%、43.2%、16.2%、6.5%,Ⅰ、Ⅱ、Ⅲ期的累积生存率显著高于Ⅳ、Ⅴ期(χ~2=7.239、6.152、3.992,12.354、13.171、15.084,P＜0.05).按照AJCC第5版分期统计的Ⅰ、Ⅱ、Ⅲ、Ⅳ期的累积生存率分别为71.4%、40.9%、10.2%、5.8%,Ⅰ、Ⅱ期生存率显著高于Ⅲ、Ⅳ期(χ~2=18.286、23.729,5.541、13.607,P＜0.05),Ⅲ期生存率显著高于Ⅳ期(χ~2=7.758,P＜0.05).按照AJCC第6版分期统计的Ⅰ、Ⅱ、Ⅲ、Ⅳ期的累积生存率分别为51.1%、11.7%、8.2%、6.5%,Ⅰ、Ⅱ期生存率相对较低,但Ⅰ期生存率显著高于Ⅱ、Ⅲ、Ⅳ期(χ~2=15.300,21.956,31.397,P＜0.05),Ⅱ期生存率显著高于Ⅳ期(χ~2=8.789,P＜0.05),而Ⅱ期与Ⅲ期没有差别,Ⅲ期与Ⅳ期没有差别.结论 AJCC第5版分期仍足较理想的胆囊癌分期方法,Nevin分期不够完整,AJCC第6版分期过于严格.     

Ki-67与乳腺癌临床、病理及钼靶BI-RADS分级的关系

目的探究Ki-67与乳腺癌患者临床、病理及钼靶BI-RADS分级的关系。方法回顾性分析2015年1月~2016年12月孝感市中心医院甲乳外科收治的199例女性乳腺癌患者的临床、病理及钼靶BI-RADS分级资料。结果 Ki-67指数与肿瘤直径、淋巴结转移情况、钼靶BIRADS分级、ER、PR、HER-2及浸润性导管癌WHO分级均有关(均P0.05),与年龄无关(P0.05)。髓样癌Ki-67指数平均值(61.47%)大于浸润性导管癌(36.26%)、粘液癌(15.10%)、浸润性小叶癌(20.62%)及导管内癌(12.53%)(均P0.05)。浸润性导管癌Ki-67指数平均值大于粘液癌及导管内癌(均P0.05)。Luminal B型(35.43%)、HER-2阳性型(39.58%)及三阴性型(57.26%)Ki-67平均值均大于Luminal A型(7.23%)(均P0.05),Luminal B型Ki-67平均值小于HER-2阳性型(P0.05)。三阴性型Ki-67平均值大于非三阴性型(30.20%)(P0.05)。结论 Ki-67指数与乳腺癌患者临床、病理及钼靶BI-RADS分级均有关,对乳腺癌的治疗和判断预后具有指导意义。