Invasive lobular carcinoma of the breast: A special histological type compared with invasive ductal carcinoma
Invasive lobular carcinoma of the breast: A special histological type compared with invasive ductal carcinoma
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DOI：
10.1371/journal.pone.0182397
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发表时间：
2017-09-01
期刊：
影响因子：
3.7
通讯作者：
Yang, Jin
中科院分区：
文献类型：
--
作者：
Chen, Zheling;Yang, Jiao;Yang, Jin
浸润性导管癌（IDC）和浸润性小叶癌（ILC）的临床结果和治疗策略并不一致。本研究的主要目的是明确ILC和IDC临床特征和预后的差异，并根据激素受体状态和转移部位确定高危人群。检索了监测、流行病学和最终结果计划数据库，并确定了 1990 年至 2013 年诊断为 ILC 或 IDC 的患者。总共分析了 796,335 名患者，其中 85,048 名 ILC 患者（10.7%）和 711,287 名 IDC 患者（89.3%）。 ILC 组与年龄较大、肿瘤较大、分期较晚、级别较低、转移性疾病 (M1) 疾病以及阳性淋巴结-雌激素受体阳性 (ER)/孕激素受体阳性 (PR) 阳性淋巴结数量较多相关。 ILC 的总体生存率显示出早期优势，但 5 年后结果较差。就疾病特异性生存率而言，无论是早期还是长期，IDC 组均优于 ILC 组。在激素状态和转移部位亚组分析中，ER+/PR+亚组的生存率最好，而ER+/PR-亚组的结果最差，尤其是ILC队列。 ILC和IDC有不同的转移模式。 ILC组骨转移比例（91.52%）高于IDC组（76.04%），且ILC组更容易出现多个转移部位。生存分析显示，ILC 患者发生肝转移的风险较高（疾病特异性生存 [DSS]；P = 0.046），但总体生存优于骨转移组（P
The clinical outcomes and therapeutic strategies for infiltrating ductal carcinoma (IDC) and infiltrating lobular carcinoma (ILC) are not uniform. The primary objectives of this study were to identify the differences in the clinical characteristics and prognoses between ILC and IDC, and identify the high-risk population based on the hormone receptor status and metastasis sites. The Surveillance, Epidemiology, and End Results Program database was searched and patients diagnosed with ILC or IDC from 1990 to 2013 were identified. In total, 796,335 patients were analyzed, including 85,048 with ILC (10.7%) and 711,287 with-IDC (89.3%). The ILC group was correlated with older age, larger tumor size, later stage, lower grade, metastasis disease (M1) disease, and greater counts of positive lymph node-sandestrogen- receptor-positive (ER)/progesterone receptor-positive (PR) positive nodes. The overall survival showed an early advantage for ILC but a worse outcome after 5 years. Regarding the disease-specific survival, the IDC cohort had advantages over the ILC group, both during the early years and long-term. In hormone status and metastasis site subgroup analyses, the ER+/PR+ subgroup had the best survival, while the ER+/PR-subgroup had the worst outcome, especially the ILC cohort. ILC and IDC had different metastasis patterns. The proportion of bone metastasis was higher in the ILC group (91.52%) than that in the IDC (76.04%), and the ILC group was more likely to have multiple metastasis sites. Survival analyses showed patients with ILC had a higher risk of liver metastasis (disease-specific survival [DSS]; P = 0.046), but had a better overall survival than the bone metastasis group (P