同时性双侧原发性乳腺癌的临床病理特征、分子分型及预后分析
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摘要
目的分析同时性双侧原发性乳腺癌(SBPBC)的临床病理特征、分子分型及预后特点。方法 SBPBC患者44例(SBPBC组,根据肿瘤组织体积大小分为第一癌和第二癌),单侧原发性乳腺癌(UPBC)患者132例(UPBC组),对两组患者的临床病理资料、分子分型、治疗随访结果作对比分析。结果 SBPBC组44例患者中,年龄≤50岁者32例,有家族史者30例,绝经者9例(9/44); UPBC组132例患者中,年龄≤50岁者45例,有家族史者34例,绝经者81例;两组相比,P均<0. 05。SBPBC组第一癌、第二癌和UPBC组T2期患者分别为27、16和51例,SBPBC组第一癌与第二癌、UPBC组相比,P均<0. 05。SBPBC组第一癌、第二癌N2～N3期患者分别为10、3例,两者相比,P <0. 05; SBPBC组第二癌、UPBC组N0～N1期患者分别为41、106例,两者相比,P <0. 05。SBPBC组第一癌、UPBC组组织学分级为Ⅱ～Ⅲ级的患者分别为40例、121例,两者相比,P <0. 05。SBPBC组第一癌、UPBC组病理学分期为Ⅲ期+Ⅳ期的患者分别为17、37例,两者相比,P <0. 05; SBPBC组第二癌、UPBC组病理学分期为Ⅱ～Ⅳ期的患者分别为27、117例,两者相比,P <0. 05。SBPBC组第一癌、UPBC组Ki-67阳性率≥14%的患者分别为39、87例,两者相比,P <0. 05。SBPBC组第一癌乳腺导管(Luminal) A型17例、Luminal B型23例、Her-2过表达型3例、基底样型1例,第二癌Luminal A型22例、Luminal B型19例、Her-2过表达型2例、基底样型1例; UPBC组Luminal A型45例、Luminal B型46例、Her-2过表达型13例、基底样型28例; SBPBC组第一癌、第二癌与UPBC组相比,P均<0. 05。SBPBC组、UPBC组患者中位无病生存时间分别为45个月和59个月,两组相比,P <0. 05。结论与UPBC相比,SBPBC的发病年龄低且大多数发生在绝经之前,患者多有家族史,病理分级和分期较高,以浸润性导管癌为主,分子分型以Luminal B型为主,无病生存时间较短。
引文
[1]王昊天,段晶晶,毛洁飞,等.对于划分同、异时性双侧原发性乳腺癌间隔时间的探讨[J].中国癌症杂志,2016,26(2):193-195.
[2]Senkus E,Szade J,Pieczyńska B,et al. Are synchronous and metachronous bilateral breast cancers different? An immunohistochemical analysis aimed at intrinsic tumor phenotype[J]. Int J Clin Exp Pathol,2014,7(1):353-363.
[3]张慧,山长平.双侧原发性乳腺癌高危因素的研究进展[J].山东医药,2016,56(13):99-101.
[4]Jobsen JJ,van der Palen J,Ong F,et al. Bilateral breast cancer,synchronous and metachronous; differences and outcome[J].Breast Cancer Res Treat,2015,153(2):277-283.
[5]Yaman E,Ozturk B,Coskun U,et al. Synchronous bilateral breast cancer in an aged male patient[J]. Onkologie,2010,33(5):255-258.
[6]Ibrahim NY,Sroor MY,Darwish DO. Impact of bilateral breast cancer on prognosis:synchronous versus metachronous tumors[J].Asian Pac J Cancer Prev,2015,16(3):1007-1010.
[7]Wadasadawala T,Lewis S,Parmar V,et al. Bilateral breast cancer after multimodality treatment:a report of clinical outcomes in an Asian population[J]. Clin Breast Cancer,2018,18(4):727-737.
[8]Vuoto HD,García AM,Candás GB,et al. Bilateral breast carcinoma:clinical characteristics and its impact on survival[J].Breast J,2010,16(6):625-632.
[9]Kurzyński M,Mitus J,Kolodziej-Rzepa M,et al. Bilateral synchronous breast cancer developed as metachronous malignancy after therapy of other primaries[J]. Ginekol Pol,2018,89(5):235-239.
[2]Senkus E,Szade J,Pieczyńska B,et al. Are synchronous and metachronous bilateral breast cancers different? An immunohistochemical analysis aimed at intrinsic tumor phenotype[J]. Int J Clin Exp Pathol,2014,7(1):353-363.
[3]张慧,山长平.双侧原发性乳腺癌高危因素的研究进展[J].山东医药,2016,56(13):99-101.
[4]Jobsen JJ,van der Palen J,Ong F,et al. Bilateral breast cancer,synchronous and metachronous; differences and outcome[J].Breast Cancer Res Treat,2015,153(2):277-283.
[5]Yaman E,Ozturk B,Coskun U,et al. Synchronous bilateral breast cancer in an aged male patient[J]. Onkologie,2010,33(5):255-258.
[6]Ibrahim NY,Sroor MY,Darwish DO. Impact of bilateral breast cancer on prognosis:synchronous versus metachronous tumors[J].Asian Pac J Cancer Prev,2015,16(3):1007-1010.
[7]Wadasadawala T,Lewis S,Parmar V,et al. Bilateral breast cancer after multimodality treatment:a report of clinical outcomes in an Asian population[J]. Clin Breast Cancer,2018,18(4):727-737.
[8]Vuoto HD,García AM,Candás GB,et al. Bilateral breast carcinoma:clinical characteristics and its impact on survival[J].Breast J,2010,16(6):625-632.
[9]Kurzyński M,Mitus J,Kolodziej-Rzepa M,et al. Bilateral synchronous breast cancer developed as metachronous malignancy after therapy of other primaries[J]. Ginekol Pol,2018,89(5):235-239.