乳腺导管原位癌伴微浸润的临床病理特征及危险因素

摘要

Objective To explore the clinicopathological features and risk factors of breast ductal carcinoma in situ with microinvasion (DCIS-Mi).Methods A total of 141 female patients with breast cancer were enrolled .All patients were divided into DCIS group (n=584) and DCIS-Mi group(n=83) according to the postoperatively pathological results .The general data,peripheral hematological indexes,therapeutic regimen and pathological features were compared between the two groups ,and the logistic regression model was used to analyze the factors influencing the incidence of DCIS-Mi.Results The DCIS-Mi group obtained higher proportion of patients with palpable mass/menopause or patients without induced abortion history compared to the DCIS group ,and the PLT count,PLT-to-lymphocyte ratio, proportion of well-differentiated cases , negative rates of estrogen receptor and progesterone receptor , and proportion of patients with high expression of human epidermal growth factor receptor-2(HER2) or Ki-67 in the DCIS-Mi group were higher than those in the DCIS group (P<0.05).Modified radical mastectomy and chemotherapy were common in the DCIS-Mi group,while simplex mastectomy and endocrinotherapy in the DCIS group.The result of multivariate analysis showed that menopause and histological grade were independent factors influencing the incidence of DCIS-Mi(P<0.05).Conclusion Menopause and middle and senior histological grade may be the risk factors for the incidence of DCIS-Mi.%目的 探讨乳腺导管原位癌伴微浸润(DCIS-Mi)的临床病理特征及危险因素.方法 选取141例女性乳腺癌患者,根据术后病理分为导管原位癌(DCIS组)58例与DCIS-Mi组83例.比较两组患者的一般资料、外周血液学指标、治疗方案及病理学特征,并采用logistic回归模型分析影响DCIS-Mi发生的因素.结果 DCIS-Mi组可触及肿块者、绝经者及无人工流产史者比例、PLT计数、PLT/淋巴细胞比值、高分化者比例、雌激素受体及孕激素受体阴性率、人类表皮生长因子受体2(HER2)及ki-67高表达者比例均高于DCIS组(P<0.05),DCIS-Mi组多采用乳癌改良根治术及化疗,而DCIS组则以单纯乳房切除、内分泌治疗为主.多因素分析结果显示,绝经、组织学分级是影响DCIS-Mi发生的独立因素(P<0.05).结论 绝经及中、高级组织学分级可能是DCIS-Mi发生的危险因素.