乳腺浸润性微乳头状癌临床病理学特征及预后分析

目的：比较乳腺浸润性微乳头状癌（IMPC）与浸润性导管癌（IDC）的临床资料，探讨IMPC的临床病理学特点、免疫组织化学染色表达、分子分型及预后（生存曲线）情况。方法回顾性分析2008年1月至2013年10月经病理检查确诊的42例IMPC患者（IMPC组）的临床资料，观察其病理及分子分型特点，抽取同期乳腺癌中的136例IDC患者（IDC组）作为对照。结果与IDC组比较，IMPC组在生育状态、乳腺良性病史、淋巴结转移、淋巴管侵犯、软组织侵犯、乳头侵犯、TNM分期、雌激素受体（ER）表达等方面比较，差异有统计学意义（P＜0．05）；而在民族、月经状况、肿瘤家族史、临床表现、肿瘤大小、组织学分级、孕激素受体（PR）、人类表皮生长因子受体2（HER2）、Ki67、分子分型、局部复发、远处转移、无瘤生存和总生存率方面比较，差异无统计学意义（P＞0．05）；单因素分析结果显示，有淋巴结转移、ER阴性和病理分期Ⅲ期的患者2年预后较差。结论既往有乳腺良性病史与未育女性中IMPC组发病危险性较高，其2年无瘤生存情况可能与淋巴结转移、ER和病理分期有关。

The clinicopathological characteristics and prognosis in invasive micropapillary carcinoma of the breast

Objective This study aims to compare the differences of the clinical data between invasive micropapillary carcino-ma(IMPC) and invasive ductal carcinoma (IDC) ,and explore the clinicopathologic and immunohistochemical characteristics ,molec-ular subtypes and survival condition of invasive micropapillary carcinoma of the breast .Methods Forty-two IMPC from January 2008 to October 2013 compared with 136 patients identified as IDC in this hospital during the same period .The clinicopathologic characteristics and molecular subtypes were analyzed .Results IMPC significantly differed from the IDC patients in terms of fertili-ty status ,history of benign breast ,lymph node metastasis ,lymphatic invasion ,extranodal extention ,mammilla invasion ,TNM stage , ER expression(P<0 .05) .Meanwhile no statistically significant found in the differential expression of nationality ,menopausal sta-tus ,tumor family history ,clinical presentation ,tumor size ,histological grade ,PR ,HER2 ,Ki67 ,molecular typing ,local recurrence , distant metastasis ,disease-free survival and overall survival .Univariate analysis showed that the patients who lymph node metasta-sis ,ER-negative ,TNM stage Ⅲ had the poor prognosis at 2-year disease-free survival .Conclusion The women who have the histo-ry of benign breast disease and infertility may have higher risk in the incidence of IM PC .Its 2 year disease-free survival may related with lymph node metastasis ,ER and pathological staging .