乳腺粘液腺癌的临床病理特征及预后分析

  目的  探讨乳腺粘液腺癌（mucinous breast carcinoma，MuBC）的临床病理特征及其与预后的关系，为患者个性化治疗方案的制订提供参考。  方法  回顾性收集2008年1月至2021年9月云南省肿瘤医院收治的139例MuBC患者的临床及病理资料，将其分为76例单纯型粘液腺癌（pure mucinous breast carcinoma，PMuBC）组和63例混合型粘液腺癌（mixed mucinous breast carcinoma，MMuBC）组并进行比较。采用COX比例风险回归模型确定MuBC的预后因素，Kaplan-Meier法和log-rank检验用于生存分析。  结果  PMuBC组的10 a总生存率较MMuBC组高（98.6% vs 83.7%，P = 0.019）。PMuBC组淋巴结未受累的比例（81.6% vs 47.6%，P < 0.001）高于MMuBC组。COX多因素分析显示:肿瘤大小为T1期（P = 0.005）、肿瘤大小为T2期（P = 0.006）和PR阳性（P = 0.033）是预后的保护因素。淋巴结受累达N3期（P = 0.052）与合并远处转移（P = 0.025）是预后的危险因素。  结论  肿瘤大小、淋巴结转移情况、是否远处转移和PR状态是MuBC的独立预后因素，PMuBC较MMuBC淋巴结转移率低、PR阳性率高，预后更好。

Clinicopathological Features and Prognosis of Mucinous Breast Carcinoma

  Objective  To investigate the clinicopathological characteristics of mucinous breast carcinoma （MuBC） and its relationship with prognosis, so as to provide reference for patients to make a personalized treatment plan.   Methods  The clinical and pathological data of 139 MuBC patients admitted to Yunnan Cancer Hospital from January 2008 to September 2021 were retrospectively collected. They were divided into pure mucinous breast carcinoma （PMuBC） group （n = 76） and mixed mucinous breast carcinoma （MMuBC） group （n = 63）, and compared between two groups. COX proportional hazards regression model was used to determine the prognostic factors of MuBC.Kaplan-Meier and log-rank tests were used for survival analysis.   Results  The 10-year overall survival rate of PMuBC group was higher than that of MMuBC group （98.6% vs 83.7%, P = 0.019）. The proportion of uninvolved lymph nodes （81.6% vs 47.6%, P < 0.001） in PMuBC group was higher than those in MMuBC group.COX multivariate analysis showed that tumor size was stage T1 （P = 0.005）, tumor size was stage T2 （P = 0.006） and positive PR （P = 0.033） were prognostic protective factors. Lymph node involvement reached stage N3 （P = 0.052） and distant metastasis （P = 0.025） are prognostic risk factors.  Conclusions  Tumor size, lymph node metastasis, distant metastasis and PR status are independent prognostic factors for MuBC. Compared with MMuBC, PMuBC has lower lymph node metastasis rate, higher positive rate of PR and better prognosis.