具有微乳头状结构的乳腺黏液癌临床病理学观察及预后因素分析

李　圆; 顾文贤; 周晓莉; 耿　翔; 孙阳阳

doi:10.19401/j.cnki.1007-3639.2020.11.007

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具有微乳头状结构的乳腺黏液癌临床病理学观察及预后因素分析

更新时间：2026-01-27

- 具有微乳头状结构的乳腺黏液癌临床病理学观察及预后因素分析
- Clinicopathological observation and prognostic analysis of pure mucinous breast carcinoma with micropapillary pattern
- 中国癌症杂志 2020年30卷第11期页码：897-904
- 作者机构：
  
  1. 南京医科大学附属常州市第二人民医院甲乳外科,江苏,常州,213000
  2. 南京医科大学附属常州市第二人民医院病理科,江苏,常州,213000
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2020.11.007
  中图分类号：
- 网络出版：2020-12-08，
  
  纸质出版：2020-12-08
- 稿件说明：
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李　圆, 顾文贤, 周晓莉, 耿　翔, 孙阳阳 . 具有微乳头状结构的乳腺黏液癌临床病理学观察及预后因素分析[J]. 中国癌症杂志, 2020, 30(11): 897-904.

LI Yuan, GU Wenxian, ZHOU Xiaoli, et al. Clinicopathological observation and prognostic analysis of pure mucinous breast carcinoma with micropapillary pattern[J]. China Oncology, 2020, 30(11): 897-904.
李　圆, 顾文贤, 周晓莉, 耿　翔, 孙阳阳 . 具有微乳头状结构的乳腺黏液癌临床病理学观察及预后因素分析[J]. 中国癌症杂志, 2020, 30(11): 897-904. DOI： 10.19401/j.cnki.1007-3639.2020.11.007.

LI Yuan, GU Wenxian, ZHOU Xiaoli, et al. Clinicopathological observation and prognostic analysis of pure mucinous breast carcinoma with micropapillary pattern[J]. China Oncology, 2020, 30(11): 897-904. DOI： 10.19401/j.cnki.1007-3639.2020.11.007.

摘要

背景与目的：乳腺黏液癌是一种好发于老年女性且预后较好的乳腺癌，形态学上表现为细胞外间质内有大量黏液，其中漂浮着癌细胞。在伴有黏液分泌的乳腺浸润癌中可见黏液湖中漂浮的肿瘤细胞呈微乳头状，将之命名为具有微乳头状结构的乳腺黏液癌（pure mucinous breast carcinoma with micropapillary pattern，MUMPC）。探讨MUMPC的临床病理学特征，并分析患者的预后影响因素。方法：回顾性分析2010年1月—2018年12月南京医科大学附属常州市第二人民医院收治的40例MUMPC患者的临床病理学资料。计数资料两组间比较采用χ

检验或精确概率检验，应用Kaplan-Meier法计算生存率，log-rank检验和COX回归模型进行单因素和多因素预后影响分析。结果：40例患者均为女性，年龄30~80岁，中位年龄56岁，40例患者均获得术后随访，随访时间为8.0~89.0个月，中位随访时间为60.0个月，1、3和5年无病生存（disease-free survival，DFS）率为100%、87%和62%，1、3和5年总生存（overall survival，OS）率为100%、95%和85%。单因素分析结果显示，肿瘤临床TNM分期、肿瘤最大径、淋巴结转移、脉管侵犯、肿瘤细胞核级别、神经内分泌标志、分子分型、Ki-67增殖指数是影响MUMPC患者预后的相关因素（P＜0.05）。多因素分析结果显示，肿瘤临床TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素（P＜0.05）。结论：MUMPC发病率较低，5年OS率较高。TNM分期、肿瘤细胞核级别、淋巴结转移是影响MUMPC患者预后的独立危险因素。

Abstract

Background and purpose: Mucinous breast carcinoma is a kind of breast cancer that is prone to occur in elderly women with a good prognosis. Morphologically

it is characterized by a large amount of mucus in the extracellular stroma

in which cancer cells are floating. In infiltrating carcinoma of the breast with mucus secretion

tumor cells floating in mucus lake can be observed in a micropapillary shape. It is named as pure mucinous breast carcinoma with micropapillary pattern (MUMPC). This study aimed to explore the clinicopathological features of MUMPC and analyze the prognostic factors in patients with MUMPC. Methods: The clinicopathological data of 40 patients with MUMPC admitted to Changzhou Second People’s Hospital affiliated to Nanjing Medical University from Jan. 2010 to Dec. 2018 were retrospectively analyzed. The survival rate was calculated by Kaplan- Meier method. The log-rank test and COX regression model were used to analyze the effects of single and multiple prognostic factors. Results: All 40 patients were female

aged 30-80 years

and the median age was 56 years. All patients were followed up after surgery

with a follow-up time of 8.0-89.0 months and a median follow-up time of 60.0 months. The disease-free survival (DFS) rates at 1

3 and 5 years were 100%

87% and 62%

and overall survival (OS) rates at 1

3 and 5 years were 100%

95% and 85%. The results of single factor analysis showed that TNM stage

maximum tumor diameter

lymph node metastasis

vascular invasion

nuclear grade

neuroendocrine markers

molecular typing and Ki-67 proliferation index were the relevant factors affecting the prognosis of MUMPC patients (P0.05). The results of multivariate analysis showed that TNM stage

nuclear grade and lymph node metastasis were the only risk factors affecting the prognosis of MUMPC patients (P0.05). Conclusion: The incidence of MUMPC was relatively low

and the 5-year OS rate was relatively high. TNM stage

tumor nuclear grade and lymph node metastasis were independent risk factors affecting the prognosis of MUMPC patients.

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