目的

探讨乳腺导管原位癌(DCIS)患者微浸润(MI)与其他临床病理参数的关系。

方法

回顾性分析2006年10月至2012年10月本院收治的131 例乳腺DCIS 患者的临床资料,采用Spearman 相关性分析检验DCIS-MI、淋巴结转移与其病理分级之间是否具有相关性,采用Fisher 确切概率法分析DCIS-MI 是否影响其淋巴结转移,比较DCIS 手术方式、病理级别、微浸润、腋窝淋巴结清扫是否影响其复发。

结果

(1)在131 例DCIS 的病理分级中,低级别60 例(45.8%),中级别60 例(45.8%),高级别11 例(8.4%), 各组DCIS-MI 分别有12 例、31 例、8 例,与病理分级之间具有相关性(r=0.375,P=0.000)。(2)共计76 例行前哨淋巴结活组织检查,3 例转移;56 例行腋窝淋巴结清扫,5 例转移。 腋窝淋巴结转移与微浸润有关(P=0.015),与病理分级之间无相关性(r=0.154,P=0.107)。 (3)本组DCIS 患者随访3月至6年,1 例中风死亡,3 例局部复发,无乳腺癌死亡。 DCIS 复发与手术方式、病理分级、微浸润、腋窝淋巴结清扫均无关(P=0.359、1.000、1.000、0.260)。

结论

DCIS 病理分级高易发生DCIS-MI;DCIS-MI易发生腋窝淋巴结转移。

Objective To investigate the correlations of microinvasion (MI) with other clinicopathologic parameters in the patients with breast ductal carcinoma in situ (DCIS).Methods The clinical data of totally 131 patients with DCIS treated in our hospital from October 2006 to October 2012 were retrospectively analyzed.Spearman correlation analysis was applied to detect the correlation between DCIS-MI, lymph node metastasis and pathologic grades. Fisher’s exact test was used to detect the correlation between DCIS-MI and lymph node metastasis, and analyze the influence of operation methods, pathologic grades, DCIS-MI and axillary lymph node dissection on recurrence.Results (1) In 131 cases of DCIS, there were 60 cases in low grade of DCIS(45.8%),60 in intermediate grade (45.8%) and 11 in high grade (8.4%). The microinvasion was found in 12,31 and 8 cases in each pathologic grade respectively, which implied that DCIS-MI was correlated with pathologic grades (r=0.375, P=0.000). (2) Seventy-six patients received sentinel lymph node biopsy and lymph node metastasis was found in 3 cases;56 patients received axillary lymph node dissection and lymph node metastasis was found in 5 cases. The incidence of axillary lymph node metastasis was related with DCIS-MI(P=0.015), but not correlated with pathologic grades (r=0.154, P=0.107). (3) During the follow-up of 3-72 months,1 case died of apoplexy,3 cases experienced a local recurrence and none died of breast cancer.The recurrence of DCIS was not related with operation methods, pathologic grades, DCIS-MI and axillary lymph node dissection (P=0.359,1.000,1.000,0.260).Conclusion The patients with higher pathologic grades of DCIS have a higher risk of DCIS-MI; the patients with DCIS-MI have a higher risk of axillary lymph node metastasis.