PROGNOSTIC FACTORS IN PRIMARY MUCINOUS BREAST-CARCINOMA
PROGNOSTIC FACTORS IN PRIMARY MUCINOUS BREAST-CARCINOMA
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DOI：
10.1093/ajcp/87.2.155
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发表时间：
1987-02-01
影响因子：
3.5
通讯作者：
CHRISTENSEN, I
中科院分区：
文献类型：
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作者：
RASMUSSEN, BB;ROSE, C;CHRISTENSEN, I
207例粘液性乳腺癌在形态学上分为两组：1）纯粘液性癌，仅由漂浮在丰富的细胞外粘蛋白中的实体瘤的小上皮岛组成，2）混合癌，其中肿瘤含有大面积的粘蛋白，以及缺乏细胞外粘蛋白的浸润性癌区域。207例肿瘤中，单纯型95例，混合型112例。纯癌和混合癌在一些预后因素方面有显著差异，其中最重要的是淋巴结状态。与混合癌患者相比，纯粘液癌患者在初次手术时淋巴结转移明显较少（P = 0.0001），无复发生存期明显较长（P = 0.03）。在淋巴结状态和无复发生存率方面，混合癌患者与浸润性导管癌（未另作说明）患者非常相似。在多变量分析中，预测207例患者无复发生存率的最重要因素是淋巴结状态。然而，在94例纯癌中，只有6例在乳房切除术时有淋巴结转移。详细的形态学分析表明，这6例中有2例被误诊为纯粘液癌，实际上是混合型。在另外两个这些情况下，转移起源于共存的浸润性导管癌。因此，仅在两例纯粘液癌中观察到区域淋巴结转移。结论：单纯粘液癌的生物学行为不同于混合癌和浸润性导管癌NOS。因此，提出了一个新的定义，其中粘液性癌被分类为这样，只有当它是一个纯癌，和混合粘液性癌被分类根据没有细胞外粘蛋白的生产的组件。
Two hundred seven mucinous breast carcinomas were morphologically classified into two different groups: 1) pure mucinous carcinomas consisting only of areas with small epithelial islands of solid tumor floating in abundant extracellular mucin, and 2) mixed carcinoma where the tumor contains large areas of mucin, as well as areas with infiltrating carcinoma devoid of extracellular mucin. Of the 207 tumors, 95 were of the pure type and 112 of the mixed type. The pure and mixed carcinomas differed significantly with respect to a number of prognostic factors, the most important of which was lymph node status. Patients with pure mucinous carcinomas had significantly fewer lymph node metastases at the time of primary operation (P = 0.0001) and a significantly longer recurrence-free survival (P = 0.03) than patients with mixed carcinomas. Patients with mixed carcinomas closely resembled patients with infiltrating ductal carcinomas not otherwise specified (NOS) with respect to both lymph node status and recurrence-free survival. In multivariate analysis, the single most important factor for predicting recurrence-free survival among the 207 patients was lymph node status. However, of 94 pure carcinomas, only 6 had lymph node metastases at the time of mastectomy. A detailed morphologic analysis demonstrated that two of these six cases were incorrectly diagnosed as being pure mucinous carcinomas-they were actually of the mixed type. In another two of these cases, the metastases originated from a co-existent infiltrating ductal carcinoma. Thus, metastases to the regional lymph nodes were observed in only two cases of pure mucinous carcinomas. It is concluded that the biologic behavior of the pure mucinous carcinomas differs from that of both the mixed carcinomas and infiltrating ductal carcinomas NOS. Thus, a new definition is suggested, in which a mucinous carcinoma is classified as such only if it is a pure carcinoma, and mixed mucinous carcinomas are classified according to the component without extracellular mucin production.