中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (5): 383-388.doi: 10.19401/j.cnki.1007-3639.2018.05.010

• 论著 • 上一篇    下一篇

乳腺导管原位癌和乳腺导管原位癌伴微浸润的分子分型差异性研究

李 爽1,郎冠天2,余科达2,张 强1   

  1. 1. 辽宁省肿瘤医院乳腺外科,辽宁 沈阳 110042 ;
    2. 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2018-05-30 发布日期:2018-06-12
  • 通信作者: 张 强 E-mail: zhangqiang8220@126.com

Different distribution of breast cancer subtypes in breast ductal carcinoma in situ and ductal carcinoma in situ with microinvasion

LI Shuang1, LANG Guantian2, YU Keda2, ZHANG Qiang1   

  1. 1. Department of Breast Surgery, Liaoning Cancer Hospital & Institute, Shenyang 110042, Liaoning Province, China; 2. Department of Breast Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2018-05-30 Online:2018-06-12
  • Contact: ZHANG Qiang E-mail: zhangqiang8220@126.com

摘要: 背景与目的:乳腺导管原位癌伴微浸润(ductal carcinoma in situ with microinvasion,DCISMI)是乳腺导管原位癌(ductal carcinoma in situ,DCIS)发展到浸润性乳腺癌(invasive breast cancer,IDC)的中间阶段,该研究旨在分析乳腺DCIS和DCIS-MI这两类早期乳腺癌不同临床病理学特征和各个分子分型间的差异。方法:本回顾性研究纳入了317例DCIS患者,其中227例(71.6%)为纯DCIS患者,90例(28.4%)为DCIS-MI患者。所有患者根据其DCIS成分而非微浸润成分的免疫组织化学检查结果分成腔面A型[雌激素受体(estrogen receptor,ER)和(或)孕激素受体(progesterone receptor,PR)阳性,人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)阴性]、腔面B型[ER和(或)PR阳性,HER-2阳性]、HER-2过表达型(ER和PR阴性,HER-2阳性)和基底样型(ER和PR阴性,HER-2阴性)。结果:DCIS-MI患者的肿瘤大小倾向更大(P=0.059),病理核分级显著更高(P=0.002)。和DCIS患者相比,乳腺DCIS-MI患者中腔面A型比例较低而基底样型比例较高(P=0.001)。结论:乳腺DCIS和DCIS-MI间分子分型分布不同,临床病理特征迥异,提示DCIS-MI是DCIS发展的新阶段,有了“质”的改变,本结论有待后续更大样本量的研究进行验证。

关键词: 乳腺癌, 导管原位癌, 导管原位癌伴微浸润

Abstract: Background and purpose: Breast ductal carcinoma in situ with microinvasion (DCIS-MI) is considered to be the interim stage in the progression from breast ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC). We attempted to study the differences of clinicopathological features and immunohistochemistrybased subtypes of DCIS and DCIS-MI. Methods: In this retrospective study, 317 consecutive DCIS patients were recruited, including 227 (71.6%) cases with pure-DCIS and 90 (28.4%) with DCIS-MI. They were categorized into four groups: luminal-A [estrogen receptor (ER)+ and/or progesterone receptor (PR)+, human epidermal growth factor receptor 2 (HER-2)-], luminal-B (ER+ and/or PR+, HER-2+), ERBB2+ (ER-, PR-, HER-2+), and basal-like (ER-, PR-, HER-2-). Results: DCIS-MI patients tended to have larger tumor with higher nuclear grade (P=0.059 for size; P=0.002 for nuclear grade). The proportion of luminal-A tumors decreased while the proportion of basal-like tumors increased in DCIS-MI compared with pure-DCIS (P=0.001). Conclusion: Different distribution of subtypes among DCIS and DCISMI and their distinctive characteristics indicate they are distinct entities. DCIS-MI is a novel stage in the progression of DCIS with distinctive evolutions. Further studies with larger sample size are needed to replicate our observations.

Key words: Breast cancer, Ductal carcinoma in situ, Ductal carcinoma in situ with microinvasion