Mixed invasive ductal and lobular carcinoma has distinct clinical features and predicts worse prognosis when stratified by estrogen receptor status.
Mixed invasive ductal and lobular carcinoma has distinct clinical features and predicts worse prognosis when stratified by estrogen receptor status.
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混合性浸润性导管癌和小叶癌具有独特的临床特征，根据雌激素受体状态分层时预测预后较差。
DOI：
10.1038/s41598-017-10789-x
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发表时间：
2017-09-04
影响因子：
4.6
通讯作者：
Shao ZM
中科院分区：
文献类型：
--
作者：
Xiao Y;Ma D;Ruan M;Zhao S;Liu XY;Jiang YZ;Shao ZM
为探讨浸润性导管与小叶混合性癌（IDC）的临床病理特征及预后，我们收集了209109例诊断为浸润性导管癌（IDC）、浸润性小叶癌（ILC）或浸润性小叶癌（IDC- l）的原发性乳腺癌患者。发现IDC- l患者肿瘤分级较低，激素受体阳性比例高于IDC患者。此外，与ILC患者相比，IDC-L患者更年轻，激素受体状态相似。Kaplan-Meier图显示，IDC- l患者的乳腺癌特异性生存率（BCSS）显著优于IDC患者（P < 0.001），并有优于ILC患者的趋势（P = 0.166）。然而，在调整临床病理因素后，IDC-L的生存优势消失。亚组分析显示，在1级、2级、er阳性和er阴性亚组中，IDC- l的风险比（hr）高于IDC。er阳性和er阴性亚组的生存分析显示，IDC- l预测的预后比IDC差。总之，与IDC和ILC相比，IDC- l是一种不同的组织学亚型。较低的分级和较高的er阳性比例是预后较好的主要原因。在er阳性和er阴性亚组中，IDC- l预测的预后比IDC差，提示以IDC为基础的治疗不足，需要升级治疗。
In order to investigate clinicopathological characteristics and prognosis of mixed invasive ductal and lobular carcinoma (IDC-L), 209,109 primary breast cancer patients diagnosed with invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC) or IDC-L were included. It was found that IDC-L patients had lower tumor grade and higher hormone receptor positive proportions than IDC patients. Moreover, IDC-L patients were younger and had a similar hormone receptor status compared with ILC patients. Kaplan-Meier plots showed that the breast cancer-specific survival (BCSS) of IDC-L patients was significantly better than IDC patients (P < 0.001) and tended to be better than ILC patients (P = 0.166). However, after adjusting for clinicopathological factors, survival advantage of IDC-L disappeared. Subgroup analysis indicated that IDC-L had higher hazard ratios (HRs) than IDC in grade 1, grade 2, ER-positive and ER-negative subgroups. Survival analysis in ER-positive and ER-negative subgroups showed that IDC-L predicted a worse prognosis than IDC. In conclusion, IDC-L is a distinct histological subtype compared with IDC and ILC. Lower grade and higher ER-positive proportions mainly contribute to its better prognosis. In both ER-positive and ER-negative subgroups, IDC-L predicts worse prognosis than IDC, which suggested the inadequacy of IDC-based therapy and the need of escalated therapy.
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影响因子：
3.8
作者：
Turashvili, Gulisa;Bouchal, Jan;Baumforth, Karl;Wei, Wenbin;Dziechciarkova, Marta;Ehrmann, Jiri;Klein, Jiri;Fridman, Eduard;Skarda, Jozef;Srovnal, Josef;Hajduch, Marian;Murray, Paul;Kolar, Zdenek
通讯作者：
Kolar, Zdenek
影响因子：
5
作者：
Nyante, Sarah J.;Dallal, Cher M.;Brinton, Louise A.
通讯作者：
Brinton, Louise A.
DOI：
10.6004/jnccn.2016.0037
发表时间：
2016-03-01
影响因子：
13.4
作者：
Gradishar, William J.;Anderson, Benjamin O.;Kumar, Rashmi
通讯作者：
Kumar, Rashmi
影响因子：
8.8
作者：
Li, CI;Uribe, DJ;Daling, JR
通讯作者：
Daling, JR
影响因子：
64.5
作者：
Ciriello G;Gatza ML;Beck AH;Wilkerson MD;Rhie SK;Pastore A;Zhang H;McLellan M;Yau C;Kandoth C;Bowlby R;Shen H;Hayat S;Fieldhouse R;Lester SC;Tse GM;Factor RE;Collins LC;Allison KH;Chen YY;Jensen K;Johnson NB;Oesterreich S;Mills GB;Cherniack AD;Robertson G;Benz C;Sander C;Laird PW;Hoadley KA;King TA;TCGA Research Network;Perou CM
通讯作者：
Perou CM