乳腺浸润性小叶癌临床病理分析

乳腺浸润性小叶癌的临床病理分析

Clinical Pathological Analysis of Puncture Biopsy Breast Cancer

(PBBC)

中文摘要

Abstract

[目的]：分析乳腺浸润性小叶癌患者的临床病理特征，探讨乳腺浸润性小叶癌的疾病规律和特点。

[Target]: Analyze the clinical pathological of patients who suffer PBBC (Puncture Biopsy Breast Cancer), and discuss the rules and characteristics of PBBC.

[材料和方法]：2001年1月至2008年12月间在我院经过手术治疗，经病理证实为原发乳腺浸润性小叶癌患者68例。统计患者年龄分布、月经状况、肿瘤位置、超声检查、X线钼靶摄片检查、TNM 分期以及免疫组化等临床特点和肿瘤病理特点，并与乳腺浸润性导管癌相关资料进行比较和分析。

[Information and Methods]: between January 2001 and December 2008, 68 patients who had operation in our hospital are diagnosed to be suffering PBBC. The writer statistics these patients’ information on a series of clinical features and pathology features including age, menstruation condition, position of tumor, ultrasonic examination, molybdenum target X-ray, TNM period, and Envision TM, and then compare and analyze the features with other PBBC documents.

[结果]：乳腺浸润性小叶癌的发病高峰年龄在40-49岁，共29例

（42.7%）；其次是50-59岁，16例（23.5%）。其中年龄最小者30岁，最大者79岁，平均年龄50.2岁；绝经前病人共39例（57.4%），已绝经29例（42.6%）；原发肿瘤发生在左侧乳腺的有31例（45.6%）,发生在右侧乳腺的有35例（51.5%）原发于双侧者2例（2.9%）。原发于乳腺的外上象限最多，27例（45.0%）。术前超声检查4例均有阳性表现，X线钼靶摄片12例，阳性表现11例（91.7%）；按照AJCC的TNM分期，Ⅰ期8例（12.9%），Ⅱ期37例（59.7%），Ⅲ期17例（27.4%）；免疫组化情况，ER阳性55例（87.3%），PR 的阳性56例（88.9%），HER-2阳性14例（22.2%）。ILC与IDC 患者年龄分布，月经状况，肿瘤大小方面同IDC无显著差异（P＞0.05），在腋窝淋巴结阳性比率、ER、PR的阳性率、HER-2的阳性率方面同IDC有显著差别（P＜0.05）。

[Outcome]: peak age of PBBC is between 40 and 49, which period has 29 patients (42.7%); then following the age between 50 and 59, which has 16 patients (23.5%). The youngest patient is 30 years old while the eldest is 79.The average age of the tested people are 50.2. 39 women (57.4%) does not menopause, and 29 women (42.6%) reach menopause already. 35 cases (45.6%) occurs on the left breast, 35 cases (51.5) occurs on the right side, and 2 cases (2.9%) occurs on both sides. Most cases (27 cases, 45% of the overall cases) start from the outer upper guardant. Four patients have positive effect on ultrasonic examination before operation, 11 out of 12 in molybdenum target X-ray (91.7%). According to the

AJCC TNM, the figures are: 8 cases (12.9%) in period I, 37 (59.7%) in period II, 17(27.4%) in period III; Envision TM is as follows: 55 cases ER+ (87.3%), 56 cases PR+ (88.9%), 14 cases HER-2+ (22.2%).There is no different between ILC and IDC with patients’ age, menstruation condition and the size of tumor (P>0.05), but there are apparent difference with the ratio of positive axillary nodes, ratio of ER+ and PR+, and ratio of HER-2+（P＜0.05）.

[结论]：ILC病人的发病年龄高峰在40-49岁,同乳腺癌整体发病年龄结构符合。ILC的钼靶摄影表现有时不典型，综合运用超声及X 线钼靶摄片进行影像学检查，有助于明确诊断。临床所见ILC的分期中，II期病例人数最多。ILC同IDC相比，在年龄，月经状况，肿瘤大小上无显著差别。ILC的ER、PR高表达，HER-2低表达,同IDC 差别明显，提示内分泌治疗收益大。

[Conclusion]peak age of PBBC is between 40 and 49, similar as general breast cancer. The feature of ILC through molybdenum target is not clearly. Adapt ultrasonic examination and molybdenum target X-ray will help clarity a diagnosis. In the clinic ILC, most cases occur in period II. Compare ILC with IDC, there are not significant differences between age, menstruation condition and the size of tumor. High ER and PR, and low HER-2 in ILC, apparently different from IDC, indicate that there are much benefits by using Hormone therapy.

[关键词]：乳腺癌，浸润性小叶癌，临床病理，免疫组化