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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 332 -336. doi: 10.3877/cma.j.issn.1674-0785.2020.05.003

所属专题： 乳腺疾病； 总编推荐； 经典病例； 文献；

乳腺癌·临床研究

炎性乳腺癌临床病理分析25例
王伟1, 辛灵1, 张虹2, 张爽2, 徐玲1, 刘倩1, 叶京明1, 刘荫华1,†()   
  1. 1. 100034　北京大学第一医院乳腺疾病中心
    2. 100034　北京大学第一医院病理科
  • 收稿日期:2020-02-24 出版日期:2020-05-15
  • 通信作者: 刘荫华
  • 基金资助:
    国家重点研发计划(2016YFC0901302); 应用液体活检技术检测乳腺癌临床疗效的研究(2017-2019)

Clinicopathologic characteristics of inflammatory breast cancer cases: analysis of 25 cases

Wei Wang1, Ling Xin1, Hong Zhang2, Shuang Zhang2, Ling Xu1, Qian Liu1, Jingming Ye1, Yinhua Liu1,†()   

  1. 1. Breast Cancer Center, Peking University First Hospital, Beijing 100034, China
    2. Department of Pathology, Peking University First Hospital, Beijing 100034, China
  • Received:2020-02-24 Published:2020-05-15
  • Corresponding author: Yinhua Liu
  • About author:
    Corresponding author: Liu Yinhua, Email:
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王伟, 辛灵, 张虹, 张爽, 徐玲, 刘倩, 叶京明, 刘荫华. 炎性乳腺癌临床病理分析25例[J/OL]. 中华临床医师杂志(电子版), 2020, 14(05): 332-336.

Wei Wang, Ling Xin, Hong Zhang, Shuang Zhang, Ling Xu, Qian Liu, Jingming Ye, Yinhua Liu. Clinicopathologic characteristics of inflammatory breast cancer cases: analysis of 25 cases[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(05): 332-336.

目的

研究炎性乳腺癌的临床病理特征及影响预后的相关因素。

方法

回顾性分析2012年1月至2018年12月北京大学第一医院乳腺疾病中心收治炎性乳腺癌患者的临床病理资料，探讨影响预后的相关因素。

结果

25例临床病理资料完整的炎性乳腺癌患者纳入分析，占同期收治新发乳腺癌患者的0.89%（25/2811）。临床分期Ⅲ期17例（68%），Ⅳ期8例（32%），预后分期Ⅲ期17例（68%），Ⅳ期8例（32%）。Luminal B型（HER-2阴性）9例（36%），HER-2阳性型5例（20%）及三阴型11例（44%）。19例患者接受手术治疗，R0切除率94.7%（18/19）。中位生存时间18.2个月，预后分期ⅢB期、ⅢC期和Ⅳ期患者2年总生存率分别为72.9%，66.7%和15.6%（χ2=13.247，P<0.001），差异具有统计学意义。

结论

炎性乳腺癌临床发病率不高，但是病期晚，预后差。在接受新辅助治疗后90%以上的患者可以获得局部R0切除。

关键词: 炎性乳腺癌, 分子分型, 预后
Objective

To investigate the clinicopathologic features and prognostic factors of inflammatory breast cancer (IBC).

Methods

We retrospectively analyzed the clinicopathologic characteristics and outcomes of patients with IBC diagnosed at Peking University First Hospital from January 2012 to December 2018.

Results

A total of 25 patients with IBC were included, accounting for 0.89% (25/2811) of newly diagnosed breast cancer cases at our center. All patients had complete clinicopathologic data and follow-up results. Seventeen (68%) patients had stage Ⅲ IBC, and eight (32%) had stage Ⅳ disease. The numbers of patients with luminal B (HER-2 negative), HER-2 positive, and triple-negative breast cancer were 9 (36%), 5 (20%), and 11 (44%), respectively. Nineteen patients underwent surgery, 94.7% of whom achieved local R0 resection. The median survival time was 18.2 months. The 2-year overall survival rates of patients with prognostic stage ⅢB, stage ⅢC, and stage Ⅳ disease were 72.9%, 66.7%, and 15.6%, respectively; there was a significant difference among them (χ2=13.247, P<0.001).

Conclusion

IBC is a rare, aggressive disease with advanced stage and poor disease outcome. Local R0 resection can be achieved in more than 90% of patients after neoadjuvant therapy.

Key words: Inflammatory breast cancer, Molecular subtype, Prognosis
表1 25例炎性乳腺癌患者的临床病理资料
临床特征 例数（%）
年龄（岁） ?
? <35 5（20）
? ≥35 20（80）
月经状态 ?
? 绝经前 18（72）
? 绝经后 7（28）
分子分型a ?
? Luminal B型（HER-2阴性） 9（36）
? HER-2阳性型 5（20）
? 三阴型 11（44）
组织学分级 ?
? 1 1（4）
? 2 7（28）
? 3 17（68）
临床分期b ?
? ⅢB 15（60）
? ⅢC 2（8）
? Ⅳ 8（32）
预后分期b ?
? ⅢB 11（44）
? ⅢC 6（24）
? Ⅳ 8（32）
Ki-67 ?
? <15% 0
? 15%~30% 7（28）
? >30% 18（72）
脉管癌栓 ?
? 有 8（32）
? 无 17（68）
图1 不同预后分期炎性乳腺癌患者总生存期
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