乳腺叶状肿瘤89例临床分析

目的:探讨乳腺叶状肿瘤的临床特点及影响预后的因素。方法:对我院收治的89例经病理确诊的乳腺叶状肿瘤临床资料进行回顾性分析。结果:89例患者均行手术治疗,肿块切除15例;乳腺区段切除16例;乳腺单纯切除26例;改良根治术32例。术后病理腋窝淋巴结转移1例。全组共有13例局部复发,局部复发率为14·6%(13/89)。肿块切除、乳腺区段切除、乳腺单纯切除和改良根治术者的局部复发率分别为60·0%(9/15)、12·5%(2/16)、7·7%(2/26)和0(0/32),差异有统计学意义,P<0·01。5例有远处转移,其中3例肺转移,1例脑转移,1例胰腺转移。用Cox比例风险模型分析影响生存预后的因素,远处转移是影响生存预后的主要因素,P<0·01。结论:乳腺叶状肿瘤确诊有赖术后病理检查。行肿块切除术的复发率较高,必须慎用;腋窝淋巴结转移率低,腋窝清除不需常规进行。预后较好,远处转移是影响生存预后的主要因素。

Phyllodes Tumor of Breast: Clinical Analysis of 89 Patients

OBJECTIVE:To explore the clinical characteristics of phyllodes tumor of breast and analyzed the factors influencing the prognosis. METHODS: From June, 1965 to April, 2004, 89 patients with phyllodes tumor of breast that were admitted in our hospital were analyzed retrospectively. RESULTS: 15 patients underwent lumpectomy, 16 patients underwent quadrantectomy, 26 patients underwent mastectomy, 32 patients underwent modified radical mastectomy and the local recurrent rates are 60.0%(9/15),12.5%(2/16), 7.7%(2/26), 0.0%(0/32), respectively and there was significant statistical differences, P<0.01. One patient had axillary lymph node metastasis. Three patients had pulmonary metastasis, 1 patient had cerebral metastasis, 1 patient had pancreatic metastasis. Cox regression was used for multivariate analysis of the data, distant metastasis was found to affect the survival, P<0.01. CONCLUSIONS: Phyllodes tumor of breast was often confirmed by the postoperative pathological examination. Lumpectomy was not suggested for the high local recurrent rate. Axillary dissection was not recommended routinely for low lymph node positive rate. The prognosis was relatively good and distant metastasis was the major factor that affected survival.