作　　者： (凌泓）; (徐晓丽）;

机构地区： 复旦大学附属肿瘤医院乳腺外科,复旦大学上海医学院肿瘤学系,上海200032

出　　处： 《中国癌症杂志》 2017年第8期655-660,共6页

摘　　要： 背景与目的:乳房派杰氏病(Paget’s disease)是一种很罕见的疾病。文献报道该病患者的生存情况与其下乳房内的病灶的恶性程度相关。该研究旨在探索合并浸润性乳腺癌的乳房派杰氏病的临床病理特征并分析患者的生存率。方法:2002—2007年,共54例在复旦大学附属肿瘤医院接受治疗的合并浸润性乳腺癌的乳房派杰氏病患者纳入该研究。由于乳腺派杰氏病大多数为人表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)阳性,研究者随机收集了同期72例HER-2阳性浸润性乳腺癌患者作为对照组,比较两组的生存差异。结果:25例(46.3%)研究组患者没有典型的乳头乳晕派杰氏病皮肤表现,35例(64.8%)研究组患者浸润性癌灶超过2 cm,26例(48.1%)研究组患者腋窝淋巴结有转移。与对照组的患者相比,派杰氏病患者的复发事件更多(5年无复发生存率:76.4%vs 48.5%,P<0.01)。对照组复发事件多集中于术后3年内,而派杰氏患者复发风险在术后5年内持续存在。研究组的5年总生存率(61.0%)也低于对照组(80.6%,P=0.01)。结论:合并浸润性癌的乳房派杰氏病患者比HER-2阳性乳腺癌患者的预后差。 Background and purpose： Paget’s disease （PD） of the breast is a rare disease. The survival of PD was reported to be related to the characteristics of the underlying carcinoma. This study aimed to investigate the char-acteristics and survival of PD patients with underlying invasive breast carcinoma （IBC）. Methods： Fifty-four patients diagnosed with PD and an associated IBC in Fudan University Shanghai Cancer Center from 2002 to 2007 were re-cruited in this study as study group. Since most PD overexpress HER-2, 72 patients with HER-2-overexpressing breast cancer were randomly recruited as control group. This study compared survival between these two groups. Results： Twenty-fve （46.3%） patients in study group had no clinical manifestation of PD and were diagnosed unexpectedly by a histologic examination. Thirty-fve （64.8%） patients in study group had tumors larger than 2 cm, twenty-six（48.1%） patients in study group had chance of axillary lymph node involvement. Compared with control group, patients in study group tended to have more events （5-year relapse-free survival： 76.4% vs 48.5%, P〈0.01）. In the control group, most events occurred in the frst 3 years after operation, while recurrence might happen all along in the 5 years after opera-tion in study group. Patients in study group also had a poorer overall survival than in control group （61.0% vs 80.6%, P=0.01）. Conclusion： Patients with Paget’s disease and underlying invasive breast cancer tend to have poorer survival than those with HER-2-overexpressing breast cancer.

关 键 词： 派杰氏病 人表皮生长因子受体 浸润性乳腺癌 生存分析