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中华乳腺病杂志(电子版) ›› 2025, Vol. 19 ›› Issue (05) : 296 -301. doi: 10.3877/cma.j.issn.1674-0807.2025.05.006

综述

乳腺浸润性小叶癌的治疗现状
邹莉1, 夏羽2, 陈杰3,()   
  1. 1 625300 四川省雅安市汉源县中医医院肿瘤科
    2 610000 成都,四川大学华西第二医院乳腺中心
    3 610072 成都,四川省医学科学院/四川省人民医院乳腺外科
  • 收稿日期:2024-08-05 出版日期:2025-10-01
  • 通信作者: 陈杰

treatment for invasive lobular carcinoma of the breast

Li Zou, Yu Xia, Jie Chen()   

  • Received:2024-08-05 Published:2025-10-01
  • Corresponding author: Jie Chen
引用本文:

邹莉, 夏羽, 陈杰. 乳腺浸润性小叶癌的治疗现状[J/OL]. 中华乳腺病杂志(电子版), 2025, 19(05): 296-301.

Li Zou, Yu Xia, Jie Chen. treatment for invasive lobular carcinoma of the breast[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2025, 19(05): 296-301.

乳腺浸润性小叶癌(ILC)占侵袭性乳腺癌的10%~15%,具有独特的生物学特性与临床表现,其诊断和治疗较非特殊性乳腺癌更具挑战性。ILC患者诊断年龄较大,首诊时常发生远处转移,且转移部位以骨、胃肠道、腹膜及卵巢为主,E-钙黏蛋白缺失是其核心分子特征。诊断方面,ILC临床表现不典型,影像学检查(X线、超声、MRI等)联合应用可提高诊断准确率,病理学诊断则依赖组织形态(如单行线状排列的肿瘤细胞)及E-钙黏蛋白等分子标志物检测。局部治疗中,保留乳房手术与全乳切除术的长期生存获益相近,但ILC因多灶性生长导致切缘阳性率高,全乳切除率较高;放射治疗中局部加速乳房照射因局部复发风险较高,一般不推荐用于ILC。全身治疗中,ILC对化疗敏感性较低,而内分泌治疗(尤其是芳香化酶抑制剂)疗效更显著,CDK4/6抑制剂联合内分泌治疗在HR阳性患者中显示出良好前景;抗HER-2治疗适用于少数HER-2阳性患者,免疫治疗仍处于探索阶段。目前,针对ILC的靶向治疗(如ROS1抑制剂)等临床研究正在推进。本综述总结了ILC的诊断与治疗现状,探讨其与IBC-NST的治疗差异,为临床个体化治疗提供参考。

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[12] 周继升, 李丹, 米琳, 韩江莉. 急性冠脉综合征合并对比剂禁忌患者血管内超声指导零对比剂冠状动脉介入治疗的安全性和有效性[J/OL]. 中华临床医师杂志(电子版), 2025, 19(06): 408-413.
[13] 宁雯琪, 张永利. 脓毒症心肌病的研究进展:基础、临床与展望[J/OL]. 中华临床医师杂志(电子版), 2025, 19(06): 461-466.
[14] 樊子君, 王怡婷, 胡端敏, 任怡琳, 盛颖玥, 刘天浩, 吴铁龙, 戴圆圆, 薛育政. 内镜下胃壁注射A型肉毒毒素减重的研究现状[J/OL]. 中华临床医师杂志(电子版), 2025, 19(06): 467-470.
[15] 侯雨函, 姜福金, 王苏贵. 膀胱癌免疫治疗的研究进展[J/OL]. 中华临床医师杂志(电子版), 2025, 19(06): 471-475.
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