Clinico-pathological features and prognosis of invasive micropapillary carcinoma compared to invasive ductal carcinoma: a population-based study from China.
Clinico-pathological features and prognosis of invasive micropapillary carcinoma compared to invasive ductal carcinoma: a population-based study from China.
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浸润性微乳头状癌与浸润性导管癌的临床病理特征和预后比较：一项来自中国的人群研究
DOI：
10.1371/journal.pone.0101390
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Shao ZM
中科院分区：
文献类型：
--
作者：
Shi WB;Yang LJ;Hu X;Zhou J;Zhang Q;Shao ZM
乳腺浸润性微乳头状癌（IMPC）是一种罕见的乳腺癌亚型，与区域淋巴结转移的高发生率和不良的临床结局相关。然而，IMPC的临床病理特征和预后因素还不清楚。患者与方法共纳入188例IMPC和1,289例浸润性导管癌（IDC）。比较两组患者的临床特征、乳腺癌特异性生存期（BCSS）和无复发/转移生存期（RFS）。结果IMPC患者较IDC患者表现出更多的侵袭性癌特征，包括肿瘤体积较大、肿瘤分期较高、淋巴结受累比例较高、淋巴管浸润发生率较高。IMPC患者的5年BCSS和RFS率（分别为75.9%和67.1%）低于IDC患者（分别为89.5%和84.5%）。与IDC患者相比，IMPC患者的III期乳腺癌百分比显著更高（51.3%对21.7%）。在分期匹配的Kaplan-Meier分析中，III期IMPC患者的5年BCSS和RFS率低于III期IDC患者（BCSS，P = 0.004; RFS，P = 0.034）。 多因素分析显示，TNM分期是IMPC患者的独立预后因素。IMPC中管腔样癌的比例显著高于IDC（P<0.001）。然而，在分子亚型匹配后，IMPC患者的临床结局明显差于IDC患者。结论在中国女性中，IMPC比IDC表现出更多的攻击性行为，导致IMPC患者的临床结局较差，无论其分子亚型如何。我们的研究结果表明，IMPC患者的生存率较差可能是由于TNM III期肿瘤的发病率和侵袭性增加。
Background Invasive micropapillary carcinoma (IMPC) of the breast is a rare subtype of breast cancer that is associated with a high incidence of regional lymph node metastases and a poor clinical outcome. However, the clinico-pathological features and prognostic factors of IMPC are not well understood. Patients and Methods A total of 188 IMPC cases and 1,289 invasive ductal carcinoma (IDC) cases were included. The clinical features, breast cancer-specific survival (BCSS) and recurrence/metastasis-free survival (RFS) of the patients were compared between these two groups. Results The IMPC patients exhibited more features of aggressive carcinoma than the IDC patients, including larger tumor size, higher tumor stage, a greater proportion of nodal involvement and an increased incidence of lymphovascular invasion. Patients with IMPC had lower 5-year BCSS and RFS rates (75.9% and 67.1%, respectively) than patients with IDC (89.5% and 84.5%, respectively). Compared to IDC patients, the patients with IMPC had a significantly higher percentage of stage III breast cancer (51.3% versus 21.7%). In a stage-matched Kaplan-Meier analysis, the patients with stage III IMPC had lower 5-year BCSS and RFS rates than patients with stage III IDC (BCSS, P = 0.004; RFS, P = 0.034). A multivariate analysis revealed that TNM stage was an independent prognostic factor for patients with IMPC. The proportion of cancers with a luminal-like subtype was significantly higher in IMPC than in IDC (P<0.001). However, after matching by molecular subtype, the patients with IMPC had significantly worse clinical outcomes than patients with IDC. Conclusions In Chinese women, IMPCs displayed more aggressive behaviors than IDCs, resulting in poorer clinical outcomes for patients with IMPC, regardless of a favorable molecular subtype. Our findings illustrate that the poorer survival of patients with IMPC might be due to an increased incidence and aggressiveness of tumors in TNM stage III.
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