Dose invasive apocrine adenocarcinoma has worse prognosis than invasive ductal carcinoma of breast: evidence from SEER database.
Dose invasive apocrine adenocarcinoma has worse prognosis than invasive ductal carcinoma of breast: evidence from SEER database.
复制标题
剂量浸润性顶浆腺癌的预后比乳腺癌浸润性导管癌差：来自 SEER 数据库的证据。
DOI：
10.18632/oncotarget.15597
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发表时间：
2017-04-11
期刊：
影响因子：
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通讯作者：
Yang Q
中科院分区：
文献类型：
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作者：
Zhang N;Zhang H;Chen T;Yang Q
背景乳腺浸润性顶浆腺癌（AAC）是一种罕见的乳腺癌组织病理学亚型。我们的目的是探讨AAC和浸润性导管癌（IDC）乳腺癌的不同特点和预后结果。结果与IDC相比，AAC患者年龄偏大，行为更具侵略性，ER和PR比例较低，HER 2扩增率较高，保乳治疗和辅助化疗较少。根据Kaplan-Meier分析，ACC患者的长期OS和DSS均比IDC患者差（分别为p = 0.006，p = 0.012）。然而，在匹配的两种组织学亚型之间没有检测到DSS（p = 0.181）和OS（p = 0.116）的显著差异。进一步的亚组分析表明，AJCC分期、ER状态、PR状态和HER 2状态可能是AAC预后的主要混杂因素。材料与方法纳入监测、流行病学和最终结果（SEER）数据库，共有260，596例患者符合合格标准。采用卡方检验比较各组间的临床病理特征。采用单因素和多因素分析评价总生存期（OS）和疾病特异性生存期（DSS）。亚组分析使用森林图总结了AAC与IDC的风险比（HR）。结论AAC具有独特的临床病理特征，较IDC更倾向于侵袭性。然而，在人口统计学和临床病理学因素相匹配后，预后较差的情况有所减少。需要对AAC进行更深入的了解，以促进个性化和定制化治疗，从而改善临床管理和结果。
Background Invasive apocrine adenocarcinoma (AAC) of breast is a rare histopathological subtype of breast carcinomas. We aim to investigate the different characteristics and prognostic outcomes between AAC and invasive ductal carcinoma (IDC) of breast cancer. RESULTS AAC patients presented with older ages, more aggressive behaviors, lower ER and PR proportions, higher HER2 amplification rates and less application of breast-conserving therapy and adjuvant chemotherapy compared to IDC patients. Long-term OS and DSS were both worse in ACC patients (p = 0.006, p = 0.012 respectively) than in IDC patients by Kaplan-Meier analysis. However, no significant difference was detected in DSS (p = 0.181) and OS (p = 0.116) between the matched two histological subtypes. Further subgroup analysis indicated that AJCC stage, ER status, PR status and HER2 status may be principal confounders for AAC prognosis. Materials and Methods With accession to the Surveillance, Epidemiology and End Result (SEER) database, a total of 260,596 patients met the eligibility criteria. Clinicopathological characteristics were compared between groups using Chi-square test. Univariate and multivariate analyses were applied to evaluate the overall survival (OS) and disease-specific survival (DSS). Subgroup analyses summarized the hazard ratio (HR) of AAC versus IDC using a forest plot. Conclusions AAC had unique clinicopathological characteristics and it tended to be a more aggressive type than IDC. However, the worse prognosis was diminished after matching for demographic and clinicopathological factors. Deeper insights into AAC are in need to contribute to individualized and tailored therapy, which thereby may improve clinical management and outcomes.