44例男性乳腺癌的临床病理特征分析
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摘要
目的分析44例男性乳腺癌(male breast cancer,MBC)的基本病理特征及临床资料,提高对MBC的认识。方法收集郑州大学第一附属医院、郑州大学第二附属医院及郑州市中心医院2002年1月至2017年5月收治的44例MBC患者的临床病理资料,分析其流行病学、临床表现、病理改变、治疗方法和预后。结果 MBC发病年龄12~82岁,中位年龄62岁,左右侧发病均22例,比例为1∶1,乳腺肿块为首要临床表现;Ⅲ、Ⅳ期患者共占47.8%;组织学类型以非特殊类型浸润性癌为主(77.6%);基因分型中56.9%为Luminal A型,Luminal B型36.2%,Basal-like型6.9%,未见HER-2过表达型。90.9%患者雌激素受体阳性,84.1%患者孕激素受体阳性;33例(75.0%)患者接受乳腺癌改良根治术。组织学Ⅱ级11例,组织学Ⅲ级3例,平均无瘤生存期分别为53.6、31.7个月;Luminal A型、Luminal B型和Basallike型的平均无瘤生存期分别为68.2、37.5、25.5个月。结论 MBC比较少见,发病年龄集中于老年人。非特殊类型浸润性癌是主要的病理类型,Luminal A型和Luminal B型是常见分子分型。组织学Ⅲ级及Basal-like型的患者预后较差,Luminal A型患者预后较好。
Objective The basic pathological features and clinical data of 44 male breast cancer were analyzed to improve the understanding of male breast cancer. Methods From January of 2002 to May of 2017,the data of epidemiology,clinical and pathological feature,treatment and prognosis of 44 male breast cancer patients were analyzed in the First Affiliafed Hospital of Zhengzhou University,the Second Affiliated Hospital of Zhenghzhou University,Zhengzhou Central Hospital. Results The patients were 12 to 82 years old,with a median age of 62. The primary clinical manifestation was a breast lump. Clinical stage Ⅲand Ⅳ accounted for 47. 8%,with invasive ductal cancer accounted for 77. 6%. Luminal A patients were accounted for 56. 9%,and 36. 2% patients were Luminal B,6. 9% patients were Basal-like. The percent of patients with estrogen receptor positive and progesterone receptor positive were 90. 9%,84. 1%,respectively. The disease-free survival time of patients with histologicⅡ and Ⅲ were 53. 6 months and 31. 7 months,respectively. The survival periods of Luminal A,Luminal B and Basal-like type were 68. 2 months,37. 5 months and 25. 5 months,respectively. Conclusion Male breast cancer is a rare type of disease,and the age is concentrated in old people. The predominant histological type of disease is invasive ductal cancer,Luminal A and Luminal B are common molecular typing. The prognosis of patients with histologic Ⅲ and Basal-like is poor. However,Luminal A patients have a better prognosis.
Objective The basic pathological features and clinical data of 44 male breast cancer were analyzed to improve the understanding of male breast cancer. Methods From January of 2002 to May of 2017,the data of epidemiology,clinical and pathological feature,treatment and prognosis of 44 male breast cancer patients were analyzed in the First Affiliafed Hospital of Zhengzhou University,the Second Affiliated Hospital of Zhenghzhou University,Zhengzhou Central Hospital. Results The patients were 12 to 82 years old,with a median age of 62. The primary clinical manifestation was a breast lump. Clinical stage Ⅲand Ⅳ accounted for 47. 8%,with invasive ductal cancer accounted for 77. 6%. Luminal A patients were accounted for 56. 9%,and 36. 2% patients were Luminal B,6. 9% patients were Basal-like. The percent of patients with estrogen receptor positive and progesterone receptor positive were 90. 9%,84. 1%,respectively. The disease-free survival time of patients with histologicⅡ and Ⅲ were 53. 6 months and 31. 7 months,respectively. The survival periods of Luminal A,Luminal B and Basal-like type were 68. 2 months,37. 5 months and 25. 5 months,respectively. Conclusion Male breast cancer is a rare type of disease,and the age is concentrated in old people. The predominant histological type of disease is invasive ductal cancer,Luminal A and Luminal B are common molecular typing. The prognosis of patients with histologic Ⅲ and Basal-like is poor. However,Luminal A patients have a better prognosis.
引文
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[13]程洪涛.中国妇女乳腺癌分子分型和临床病理特点及预后的联系[D].武汉:华中科技大学,2012.
[14]Deb S,Lakhani S R,Ottini L,et al.The cancer genetics and pathology of male breast cancer[J].Histopathology,2016,68(1):110-118.
[15]Murphy C E,Carder P J,Lansdown M R,et al.Steroid hormone receptor expression in male breast cancer[J].Eur J Surg Oncol,2006,32(1):44-47.
[16]Tsang J Y,Ni Y B,Chan S K,et al.Androgen receptor expression shows distinctive significance in ER positive and negative breast cancers[J].Ann Surg Oncol,2014,21(7):2218-2128.
[17]Deb S,Jene N,Fox S B,et al.Genotypic and phenotypic analysis of familial male breast cancer shows under representation of the HER2 and basal subtypes in BRCA-associated carcinomas[J].BMC Cancer,2012,12:510.
[18]Collea R P,Kruter F W,Cantrell J E,et al.Pegylated liposomal doxorubicin plus carboplatin in patients with metastatic breast cancer:a phaseⅡstudy[J].Ann Oncol,2012,23(10):2599-2605.
[19]王越华,陈德杰.38例男性乳腺癌临床病理分析[J].现代肿瘤医学,2014,22(5):1084-1087.
[20]钟慕仪,张爱玲,吴丽华,等.赫赛汀治疗Her-2阳性乳腺癌56例疗效和毒性观察[J].中国医药导报,2011,8(7):71-72.
[2]Goldhirsch A,Winer E P,Coates A S,et al.Personalizing the treatment of women with early breast cancer:highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013[J].Ann Oncol,2013,24(9):2206-2223.
[3]《乳腺癌HER2检测指南(2014版)》编写组.乳腺癌HER2检测指南(2014版)[J].中华病理学杂志,2014,(4):262-267.
[4]Javidiparsijani S,Rosen L E,Gattuso P.Male Breast Carcinoma:A Clinical and Pathological Review[J].Int J Surg Pathol,2017,25(3):200-205.
[5]Sundriyal D,Kotwal S,Dawar R,et al.Male Breast Cancer in India:Series from a Cancer Research Centre[J].Indian J Surg Oncol,2015,6(4):384-386.
[6]Giordano S H,Buzdar A U,Hortobagyi G N.Breast cancer in men[J].Ann Intern Med,2002,137(8):678-687.
[7]Doebar S.C,Slaets L,Cardoso F,et al.Male breast cancer precursor lesions:analysis of the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program[J].Mod Pathol,2017,30(4):509-518.
[8]Gnerlich J L,Deshpande A D,Jeffe D B,et al.Poorer survival outcomes for male breast cancer compared with female breast cancer may be attributable to in-stage migration[J].Ann Surg Oncol,2011,18(7):1837-1844.
[9]Korde L A,Zujewski J A,Giordano S,et al.Multidisciplinary meeting on male breast cancer:summary and research recommendations[J].J Clin Oncol,2010,28(12):2114-2122.
[10]Arslan U Y,Oksuzoglu B,Ozdemir N,et.al.Outcome of non-metastatic male breast cancer:118 patients[J].Med Oncol,2012,29(2):554-560.
[11]王翔宇,方仪,杨雪,等.男性乳腺癌的临床病理特征及生存分析[J].临床肿瘤学杂志,2016,21(4):340-344.
[12]俞星飞,封伟亮,潘晓丹,等.男性乳腺癌病理分子亚型与预后的相关性分析[J].中华肿瘤防治杂志,2011(24):1953-1955.
[13]程洪涛.中国妇女乳腺癌分子分型和临床病理特点及预后的联系[D].武汉:华中科技大学,2012.
[14]Deb S,Lakhani S R,Ottini L,et al.The cancer genetics and pathology of male breast cancer[J].Histopathology,2016,68(1):110-118.
[15]Murphy C E,Carder P J,Lansdown M R,et al.Steroid hormone receptor expression in male breast cancer[J].Eur J Surg Oncol,2006,32(1):44-47.
[16]Tsang J Y,Ni Y B,Chan S K,et al.Androgen receptor expression shows distinctive significance in ER positive and negative breast cancers[J].Ann Surg Oncol,2014,21(7):2218-2128.
[17]Deb S,Jene N,Fox S B,et al.Genotypic and phenotypic analysis of familial male breast cancer shows under representation of the HER2 and basal subtypes in BRCA-associated carcinomas[J].BMC Cancer,2012,12:510.
[18]Collea R P,Kruter F W,Cantrell J E,et al.Pegylated liposomal doxorubicin plus carboplatin in patients with metastatic breast cancer:a phaseⅡstudy[J].Ann Oncol,2012,23(10):2599-2605.
[19]王越华,陈德杰.38例男性乳腺癌临床病理分析[J].现代肿瘤医学,2014,22(5):1084-1087.
[20]钟慕仪,张爱玲,吴丽华,等.赫赛汀治疗Her-2阳性乳腺癌56例疗效和毒性观察[J].中国医药导报,2011,8(7):71-72.