中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2014年
23期
1521-1526
,共6页
刘新丽%刘芳芳%郑屹%沈蓓蓓%付丽
劉新麗%劉芳芳%鄭屹%瀋蓓蓓%付麗
류신려%류방방%정흘%침배배%부려
乳腺肿瘤%男性%分子亚型%预后%总生存%无病生存
乳腺腫瘤%男性%分子亞型%預後%總生存%無病生存
유선종류%남성%분자아형%예후%총생존%무병생존
breast neoplasm%male%molecular subtype%prognosis%overall survival%disease-free survival
目的：探讨男性乳腺癌临床病理特征、分子亚型特征及预后的特点。方法：收集天津医科大学肿瘤医院135例的男性乳腺癌患者和377例同期诊断为非特殊型浸润性导管癌女性患者临床病理资料，比较两组预后差异，对患者年龄、肿瘤大小、淋巴结转移、分期、免疫组织化学指标等因素与预后的关系进行统计学分析。结果：与女性乳腺癌相比，男性乳腺癌好发于乳晕区（P=0.001），具有较高的雌激素受体、孕激素受体阳性表达率（P<0.05）；男性乳腺癌以Luminal A和Luminal B1型为主，其所占比例高于女性乳腺癌（P<0.05）；男性乳腺癌5和10年总生存率为81.3%和68.1%、无病生存率为72.3%和50.5%，显著低于同期诊断的女性乳腺癌5、10年总生存率（91.8%、79.2%）（P=0.001）、无病生存率（82.6%、60.9%）（P=0.003）。单因素生存分析显示肿瘤大小、淋巴结转移、病理学分期、HER-2状态、分子分型是影响男性乳腺癌患者总生存和无病生存预后的因素（P<0.05），Cox多因素分析显示肿瘤大小和淋巴结转移与男性乳腺癌患者预后有关（P<0.05）。结论：男性乳腺癌较女性乳腺癌预后差，分子亚型以Luminal A和Luminal B1型为主，其所占比例高于女性乳腺癌，表明两者可能具有不同的生物学行为，早期诊断、早期治疗是改善其预后的关键。
目的：探討男性乳腺癌臨床病理特徵、分子亞型特徵及預後的特點。方法：收集天津醫科大學腫瘤醫院135例的男性乳腺癌患者和377例同期診斷為非特殊型浸潤性導管癌女性患者臨床病理資料，比較兩組預後差異，對患者年齡、腫瘤大小、淋巴結轉移、分期、免疫組織化學指標等因素與預後的關繫進行統計學分析。結果：與女性乳腺癌相比，男性乳腺癌好髮于乳暈區（P=0.001），具有較高的雌激素受體、孕激素受體暘性錶達率（P<0.05）；男性乳腺癌以Luminal A和Luminal B1型為主，其所佔比例高于女性乳腺癌（P<0.05）；男性乳腺癌5和10年總生存率為81.3%和68.1%、無病生存率為72.3%和50.5%，顯著低于同期診斷的女性乳腺癌5、10年總生存率（91.8%、79.2%）（P=0.001）、無病生存率（82.6%、60.9%）（P=0.003）。單因素生存分析顯示腫瘤大小、淋巴結轉移、病理學分期、HER-2狀態、分子分型是影響男性乳腺癌患者總生存和無病生存預後的因素（P<0.05），Cox多因素分析顯示腫瘤大小和淋巴結轉移與男性乳腺癌患者預後有關（P<0.05）。結論：男性乳腺癌較女性乳腺癌預後差，分子亞型以Luminal A和Luminal B1型為主，其所佔比例高于女性乳腺癌，錶明兩者可能具有不同的生物學行為，早期診斷、早期治療是改善其預後的關鍵。
목적：탐토남성유선암림상병리특정、분자아형특정급예후적특점。방법：수집천진의과대학종류의원135례적남성유선암환자화377례동기진단위비특수형침윤성도관암녀성환자림상병리자료，비교량조예후차이，대환자년령、종류대소、림파결전이、분기、면역조직화학지표등인소여예후적관계진행통계학분석。결과：여녀성유선암상비，남성유선암호발우유훈구（P=0.001），구유교고적자격소수체、잉격소수체양성표체솔（P<0.05）；남성유선암이Luminal A화Luminal B1형위주，기소점비례고우녀성유선암（P<0.05）；남성유선암5화10년총생존솔위81.3%화68.1%、무병생존솔위72.3%화50.5%，현저저우동기진단적녀성유선암5、10년총생존솔（91.8%、79.2%）（P=0.001）、무병생존솔（82.6%、60.9%）（P=0.003）。단인소생존분석현시종류대소、림파결전이、병이학분기、HER-2상태、분자분형시영향남성유선암환자총생존화무병생존예후적인소（P<0.05），Cox다인소분석현시종류대소화림파결전이여남성유선암환자예후유관（P<0.05）。결론：남성유선암교녀성유선암예후차，분자아형이Luminal A화Luminal B1형위주，기소점비례고우녀성유선암，표명량자가능구유불동적생물학행위，조기진단、조기치료시개선기예후적관건。
Objective:To investigate the clinicopathological features, molecular subtypes, and prognosis for male breast cancer (MBC). Methods:Clinical data of 135 MBC patients and 377 female breast cancer (FBC) patients with invasive ductal carcinoma not otherwise specified were collected. Differences between the prognostic outcomes of the two groups were compared, and the relation-ship between clinicopathological characteristics and prognostic significance was analyzed. Results:More MBC patients suffered from centrally located tumors, with mammary areola as the predilection site, than FBC patients. The two groups exhibited significant differ-ences (p=0.001). Male patients had a higher ER frequency and positive PR rate than female patients (P<0.05). The most common mo-lecular subtypes of MBC were Luminal A and Luminal B1, and significant differences were identified for molecular subtypes between MBC and FBC patients (P<0.05). The 5-year and 10-year overall survival rates in MBC patients were 81.3% and 68.1%, and dis-ease-free survival rates were 72.3%and 50.5%, respectively. These values were significantly lower than those of FBC patients in the same-period diagnostic [i.e., 91.8%and 79.2%(P=0.001), and 82.6%and 60.9%(P=0.003), respectively]. Kaplan-Meier survival analy-sis, tumor size, lymph node metastasis, pathological stage, HER-2 status, and molecular subtypes affected the prognosis of MBC pa-tients (P<0.05). In multivariate analysis, the tumor size and lymph node metastasis were associated with a poor prognosis (P<0.05). Conclusion:MBC patients experienced a more unfavorable prognosis compared with FBC patients. The most common molecular sub-types of MBC were Luminal A and Luminal B1, which were higher in proportion in MBC patients than in FBC patients. Biological dif-ferences contributed to the poor prognosis. Therefore, early diagnosis and treatment are key to improving the prognosis.
