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中华乳腺病杂志(电子版) ›› 2013, Vol. 07 ›› Issue (05) : 351 -354. doi: 10.3877/cma.j.issn.1674-0807.2013.05.008

论著

乳腺导管/小叶混合型癌的临床病理分析
吕赤1, 张忻平1, 李瑾1, 张成1, 蒋会勇1, 张雪峰1,()   
  1. 1.110840 沈阳军区总医院普通外科
  • 收稿日期:2013-06-04 出版日期:2013-10-01
  • 通信作者: 张雪峰

Clinicopathologic analysis of mixed ductal/lobular carcinoma of breast

Chi LVU1, Xin-ping ZHANG1, Jin LI1, Cheng ZHANG1, Hui-yong JIANG1, Xue-feng ZHANG1,()   

  1. 1.Department of General Surgery,General Hospital of Shenyang Military Region,Shenyang 110840,China
  • Received:2013-06-04 Published:2013-10-01
  • Corresponding author: Xue-feng ZHANG
引用本文:

吕赤, 张忻平, 李瑾, 张成, 蒋会勇, 张雪峰. 乳腺导管/小叶混合型癌的临床病理分析[J/OL]. 中华乳腺病杂志(电子版), 2013, 07(05): 351-354.

Chi LVU, Xin-ping ZHANG, Jin LI, Cheng ZHANG, Hui-yong JIANG, Xue-feng ZHANG. Clinicopathologic analysis of mixed ductal/lobular carcinoma of breast[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2013, 07(05): 351-354.

目的

比较分析乳腺导管/小叶混合型癌(mixed ductal/lobular carcinoma)与乳腺浸润性导管癌(invasive ductal carcinoma, IDC)的临床病理特征。

方法

回顾性分析2009 年7 月至2012 年12 月沈阳军区总医院普外科收治的35 例乳腺导管/小叶混合型癌及86 例IDC 的临床病理资料,比较二者的临床病理特征。计数资料采用χ2 检验及Fisher 确切概率法,等级资料采用非参数检验,多因素分析采用二分类非条件Logistic 回归分析。

结果

单因素分析显示ER、PR 阳性表达率及E-cadherin 阴性表达率混合型癌组显著高于IDC 组(χ2=4.169、 8.860、 12.392; P=0.041、0.003、0.000),多因素回归分析提示PR 和E-cadherin 是混合型癌与IDC 的独立危险因素[Exp(B)= 2.957, 95%CI=1.250 ~6.991,P=0.014;Exp(B)=0.255,95%CI=0.104 ~0.623;P=0.003]。但发病年龄、月经情况、腋窝淋巴结转移、HER-2 与Ki67 阳性表达、TNM 分期两组差异均无统计学意义(χ2 =1.442、0.979、0.455、0.010、2.364,P=0.230、0.323、0.500、0.920、0.124;Z=-0.197,P=0.844)。

结论

乳腺导管/小叶混合型癌是兼有IDC 与浸润性小叶癌临床病理特征但却独立的一种类型。

Objective

To analyze and compare the clinicpathological characteristics between mixed ductal/lobular carcinoma and invasive ductal carcinoma(IDC) of the breast.

Methods

We retrospectively analyzed the data of patients treated in Department of General Surgery, General Hospital of Shenyang Military Region from July 2009 to December 2012, including 35 cases of mixed ductal/lobular carcinoma of the breast and 86 cases of IDC and compared clinicopathologic characteristics between the two groups.Chi-square test and Fisher's exact propability were used for enumeration data, non-parametric test for ranked dat.Multivariate analysis was performend using Logistic regression analysis.

Results

Univariate analysis showed that the positive rate of ER and PR and negative expression of E-cadherin in mixed carcinoma group were significantly higher than those in IDC group(χ2 = 4.169, 8.860, 12.392; P = 0.041,0.003,0.000).Multivariate regression analysis showed that PR and E-cadherin were independent risk factors in mixed carcinoma and IDC[Exp(B)= 2.957, 95% CI=1.250 ~6.991,P=0.014;Exp(B)= 0.255,95% CI=0.104 ~0.623;P=0.003].But onset age, menstruation, axillary lymph node metastasis, HER-2 and Ki67 expression and TNM stage showed no statistically significant difference between the two groups (χ2 =1.442,0.979,0.455,0.010、2.364,P=0.230,0.323,0.500,0.920,0.124;Z=-0.197,P=0.844)

Conclusion

The mixed ductal/lobular carcinoma is a distinctive clinicopathologic type incorporating some features of both invasive lobular carcinoma and IDC.

表1 多因素回归分析赋值表
表2 混合型癌与IDC 患者临床病理特征比较
表3 PR 和E-cadherin 与组织分型差异性表达的多因素Logistic 回归分析
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