Prognostic Markers for Invasive Micropapillary Carcinoma of the Breast: A Population-Based Analysis
Prognostic Markers for Invasive Micropapillary Carcinoma of the Breast: A Population-Based Analysis
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DOI：
10.1016/j.clbc.2012.10.001
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发表时间：
2013-04-01
影响因子：
3.1
通讯作者：
Teh, Bin S.
中科院分区：
文献类型：
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作者：
Chen, Albert C.;Paulino, Arnold C.;Teh, Bin S.
由于这种乳腺癌变异的发生率很少，因此人们对浸润性微乳头状癌的临床预后因素尚不清楚。我们对 624 名患者进行的基于人群的分析（迄今为止最大规模的研究）表明，尽管区域淋巴结转移的倾向很高（>50%），但浸润性微乳头状癌患者的临床预后优于浸润性导管癌。背景：浸润性微乳头状癌 (IMPC) 是乳腺癌的一种罕见且独特的变体，具有高区域淋巴结受累倾向。由于其嗜淋巴性质，与浸润性导管癌 (IDc) 相比，IMPC 被认为预后较差。患者和方法：这项研究纳入了国家癌症研究所监测、流行病学和最终结果 (NCI SEER) 数据库中列出的 624 名诊断为乳腺 IMPC 的患者（2001-2008 年），旨在评估疾病特异性生存 (DSS) 和总生存 (OS) 的预后因素。结果：IMPC 患者的 5 年 DSS 和 OS 分别为 91.9% 和 83.8%。在已知雌激素受体 (ER) 状态的患者中，84.8% 为 ER 阳性 (ER+)，这与更好的 DSS（风险比 [HR]，0.27；P < .0002）和 OS（HR 0.45；P < .006）相关。就诊时，52.9%的淋巴结检查患者有淋巴结受累，4.1%有远处转移。具有 4 个或更多淋巴结阳性的患者的 DSS（HR 6.43；P = .0013）和 OS（HR 3.47；P = .00067）比淋巴结阴性疾病的患者更差，但具有 1 至 3 个阳性淋巴结的患者的 DSS 和 OS 与淋巴结阴性疾病的患者相似。结论：虽然IMPC具有较高的淋巴结转移倾向，但其DSS和总体预后与IDC相当。 ER 阴性 (ER-) 疾病或具有 4 个或更多阳性淋巴结的患者预后最差。这是迄今为止最大规模的 IMPC 研究，这些发现将有助于解决有关乳腺癌这种罕见组织学变异的一些不一致问题。临床乳腺癌，卷。 13，第 2 期，133-9 (C) 2013 Elsevier Inc. 保留所有权利。
The clinical prognostic factors for invasive micropapillary carcinoma are not well understood due to the rare incidence of this breast cancer variant. Our population-based analysis of 624 patients, the largest study to date, suggests that despite a high propensity for regional lymph node metastasis (>50%), patients with invasive micropapillary carcinoma have clinical prognosis that compares favorably to that of invasive ductal carcinoma.Background: Invasive micropapillary carcinoma (IMPC) is a rare and distinct variant of breast carcinoma with a high propensity for regional lymph node involvement. Because of its lymphotropic nature, IMPC is considered to have an unfavorable prognosis when compared with invasive ductal carcinoma (IDc). Patients and Methods: This study of 624 patients diagnosed with breast IMPC (2001-2008) listed in the National Cancer Institute's Surveillance, Epidemiology, and End Results (NCI SEER) database was performed to evaluate prognostic factors for disease-specific survival (DSS) and overall survival (OS). Results: The 5-year DSS and OS for patients with IMPC were 91.9% and 83.8%, respectively. Of those with known estrogen receptor (ER) status, 84.8% were ER-positive (ER+), which was associated with better DSS (hazard ratio [HR], 0.27; P < .0002) and OS (HR 0.45; P < .006). At presentation, 52.9% of the patients with lymph node examinations had nodal involvement and 4.1% had distant metastases. Patients with 4 or more positive lymph nodes had worse DSS (HR 6.43; P = .0013) and OS (HR 3.47; P = .00067) than did patients with node-negative disease, but those with 1 to 3 positive lymph nodes had DSS and OS similar to those of patients with node-negative disease. Conclusion: Although IMPC has a high propensity for lymph node metastasis, it has a DSS and overall prognosis comparable to those of IDC. Patients with ER-negative (ER-) disease or those with 4 or more positive lymph nodes have the worst prognosis. This is the largest study of IMPC to date, and these findings will help address some of the inconsistencies regarding this rare histologic variant of breast cancer. Clinical Breast Cancer, Vol. 13, No. 2, 133-9 (C) 2013 Elsevier Inc. All rights reserved.