【摘要】 目的探讨伴有浸润性微乳头状癌(IMPC)结构乳腺癌的临床病理特征和诊断标准及其与预后相关因素的关系。方法复习1989-2001年间乳腺癌存档切片,按2003年 WHO 乳腺病理学标准诊断含有 IMPC 结构的乳腺癌100例,98例获得随访结果。结果 100例具有 IMPC 结构乳腺癌中,淋巴管侵犯率69%(69/100),淋巴结转移率84.8%(84/99);98例平均随访60.1个月。结果显示,11.2%(11/98)局部复发(术后平均存活26.4个月),38.8%(38/98)远位转移(术后平均存活36.0个月),36.7%(36/98)死于肿瘤,术后5年生存率59%,10年生存率48%;单因素及多因素生存分析均显示有肿瘤家族史及淋巴管侵犯的患者预后差,内分泌治疗可降低患者死亡的风险,单因素生存分析显示术后化疗可提高患者生存率。结论伴有 IMPC 结构的乳腺癌是一种预后极差的恶性肿瘤,无论肿瘤中 IMPC 结构比例占多少都应引起重视,预后与肿瘤家族史、淋巴管侵犯有关,内分泌治疗及个体性化疗可能是提高生存率的有效方法。更多还原

【Abstract】 Objective To study the diagnostic criteria,clinicopathologic characteristics and prognosis of invasive micropapillary carcinoma(IMPC)of breast.Methods All cases of breast carcinoma diagnosed during the period from 1989 to 2001 were retrospectively reviewed.One hundred examples with IMPC component,according to the 2003 World Health Organization classification of breast tumors,were identified.The clinicopathologic features and follow-up data of these cases were analyzed.Results Amongst the 100 cases of IMPC studied,69%(69/100)had evidence of lymphovascular invasion.The incidence of regional lymph node metastasis was 84.8 %(84/99).Follow-up information was available in 98 patients(mean of follow-up duration=60.1 months).Eleven patients(11.2%)had local recurrence within a mean of 26.4 months after the operation,while 38 patients(38.8%)had distant metastases within a mean of 36.0 months.Thirty-six patients(36.7%)died of the disease.The overall 5-year survival rate was 59% and the 10-year survival rate was 48%.Univariate and multivariate analysis showed that the prognosis of patients was adversely affected by the presence of lymphovascular invasion and family history of breast cancer.On the other hand,tamoxifen therapy and adjuvant chemotherapy improved survival. Conclusions Breast carcinoma with IMPC component is associated with poor prognosis,despites the relative proportion of this architectural pattern.The overall prognosis is related to the presence of lymphovascular invasion and family history of breast cancer.Hormonal therapy and individualized chemotherapy can improve the survival rate.更多还原