Objective: To elucidate the clinicopathological characters and prognostic factors of invasive micropapillary carcinoma of the breast (IMPC) by compared with invasive ductal carcinoma, not otherwise specified of the breast (IDC). Methods: The retrospective study was performed with female patients who had undergone curative resection for breast cancer without neoadjuvant chemotherapy from June 2008 to April 2016 in Breast Center of Beijing Hospital. Forty-seven mixed or pure IMPC patients and 93 pure IDC patients(admitted in the same center from October 2008 to January 2016 ) were matched for tumor stage, nodal status and age. Follow-up was done every 3 to 6 months postoperatively. The deadline was July 31, 2016. The curves of disease free survival and overall survival were drawn by the Kaplan-Meier method, and survival rates were compared by means of the Log-rank test. Potential prognostic variables that were identified on univariate analysis were analyzed with Cox's proportional hazards regression model for multivariate analysis. The χ(2) test or Fisher's exact test was used to compare distributions across 2 groups and the Mann-Whitney U test or t test was used to analyze the medians or means of 2 groups. Results: With exact matches, the rates of lymphovascular invasion (LVI) (29.8% vs. 12.9%, χ(2)=5.885, P=0.015)and histological grade 3 (40.4% vs. 21.5%, χ(2)=-2.690, P=0.007) were both significantly higher in patients with IMPC than that in IDC group, but the survival between the two pathological types were not significantly different (all P>0.05). The percent of IMPC component didn't influence the clinicopathologic characters (all P >0.05), but a significantly longer median disease free survival (χ(2)=11.731, P=0.001) when the patients had more than 50% of IMPC component was found. Conclusions: Higher rates of LVI and histological grade 3 were found in IMPC than that in IDC, but the survival was comparable between the two groups. A longer DFS occurred in patients with IMPC component more than 50%.
目的： 比较乳腺浸润性微乳头状癌(IMPC)和浸润性导管癌的预后，探讨IMPC的预后因素。 方法： 本研究为单中心回顾性病例配对研究，收集2008年6月至2016年4月在北京医院乳腺中心接受根治性手术治疗的IMPC患者47例，按年龄、pT分期及pN分期以1∶2的比例，与2008年10月至2016年1月收治时间间隔在1年之内的IDC患者93例进行配对。术后3～6个月随访一次，直至患者出现疾病进展、死亡或至2016年7月31日随访截止。单因素分析采用Mann－Whitney U检验、t检验、χ(2)检验或Fisher精确概率检验，多因素分析采用Cox回归，Kaplan－Meier法绘制生存曲线并行Log－rank检验。 结果： IMPC组脉管内癌栓发生率(29.8%比12.9%，χ(2)＝5.885，P＝0.015)和组织学分级3级的比例(40.4%比21.5%，χ(2)＝－2.690，P＝0.007)高于IDC组。IMPC成分的比例不影响肿瘤的临床病理特征(P值均>0.05)。IMPC成分≥50%的患者，中位无病生存期延长(χ(2)＝11.731，P＝0.001)。病理类型对患者的预后无影响(χ(2)为0.011、0.373，P值均>0.05)。 结论： 在条件匹配的情况下，IMPC患者脉管内癌栓阳性率及组织学3级的比例高于IDC患者，但是两组患者的生存相当。IMPC成分≥50%的患者无病生存期延长。.
Keywords: Breast neoplasms; Carcinoma, micropapillary; Prognosis.