具有微乳头状结构乳腺黏液癌的免疫表型及预后的分析

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1、天津医科大学硕士学位论文10.神经内分泌相关指标Syn在MUMPC的表达高于对照组pMC（P=0.003），而MUMPC与IMPC相比无显著性差异（P>0.05）。11.Kaplan-Meier生存分析显示，MUMPC的无病生存（DFS）及总生存（OS）低于对照组pMC（P<0.001与P=0.004），但要明显高于IMPC。结论1.年龄、肿瘤大小、淋巴管癌栓以及MUMPC是影响单纯型黏液癌淋巴结转移的独立因素。2.肿瘤大小、淋巴结转移、核分级以及MUMPC是影响单纯型黏液癌无病生存的独立因素；淋巴结转移以及核分级是影响单纯型黏液癌总生存的独立因素。3.MUMPC是一

2、类淋巴结转移率较高、侵袭性较强、预后较差的乳腺黏液癌。4.MUMPC较IMPC的生物学行为相对惰性，与对照组pMC相比则表现较差的生物学行为，因此在分类上将其归入对照组pMC可能会造成对部分该类患者的治疗不足，但将其归入IMPC可能导致治疗过度。5.因MUMPC不良的生物学行为，临床应给与足够的重视，尤其对于年龄较年轻、淋巴结转移率较高、核分级较高、HER-2阳性率较高的MUMPC患者给予更积极地临床治疗，从而使患者受益。关键词乳腺癌黏液癌微乳头状结构免疫表型预后III万方数据天津医科大学硕士学位论文AbstractObjectiveSincethefirstrepo

3、rtaboutfivepatientsofmucinousmicropapillarycarcinoma(MUMPC)byNgin2002.MUMPChasrecentlycometoattentionassharingthesamemicropapillaryfeaturewithinvasivemicropapillarycarcinoma(IMPC).OnlyalimitedofliteratureshavereportedaboutMUMPC,andduetosmallsampleandlimitedfollow-uptime,mostoftheminferr

4、editsprognosisbasedonclinicalandpathologicalfeatures.Therewerealsonoclearlyclassification;itshouldbeclassifiedasmicropapillarysubtypesofmucinouscarcinomaormucinoussubtypesofIMPC,orasanindependentsubtypebetweenthetwotypes,itisstillunclear.ThisstudycomparedMUMPCwithconventionalpuremucinou

5、scarcinoma(pMC)withoutmicropapillarypatternsandIMPCtoanalysisclinicalpathologicalfeatures,prognosisimmunophenotypingandclassificationofMUMPC,soastoprovidethebasisforpathologicaldiagnosisandclinicaltreatment.MethodsAretrospectiveevaluationof531casespuremucinouscarcinoma(pMC)from2003-01to

6、2012-12wasperformed;caseswithmicropapillarypatterns(MUMPC)andconventionalpuremucinouscarcinoma(pMC)withoutmicropapillarypatternswereselected.134casesMUMPCwereselectedasresearchgroup,397casesconventionalpMCandhomochronous281casesIMPCwereselectedascontrolgroups.Clinicopathologicalcharacte

7、ristics,survivalanalysisandprognosiswerecomparedamongthreegroups,andfactorsthatinfluencinglymphnodemetastasisofpMC,disease-freesurvival,overallsurvivalofpMCandMUMPCalsowerestudied.Theexpressionofsecretedmucinsandneuroendocrineindicatorsweredetectedthroughimmunohistochemistryin3