Analysis Of Clinicopathological Characteristics And Prognosis Of Breast Ductal Carcinoma In Situ

Objective:The purpose is to study the differences in clinical characteristics and molecular biology of pure ductal carcinoma in situ(pure-DCIS)and ductal carcinoma in situ with cancerization of lobules(DCIS-COL)and explore the influencing factors of DCIS prognosis.Methods:This retrospective study included 288 DCIS patients,of which 232 cases were pure-DCIS patients and 56 cases were DCIS-COL patients.All patients had complete clinical and pathological data,including age,menstrual status,first symptoms,surgical methods,tumor diameter,lymph node status,postoperative recurrence and metastasis,nuclear grade,and ER,PR,HER-2,Ki-67,P53 expression data.The clinical and pathological data of the two groups were compared by theχ~2test,and the P value<0.05 was used as a statistically significant index.Statistically significant indicators between the two groups were included in the binary logistic regression analysis.The purpose is to study independent risk factors for COL in DCIS patients.Kaplan-Meier method and Log-rank test were used for survival analysis of the above clinical case data.The survival curve was drawn for the index with P value<0.05,and the risk factors affecting relapse-free survival(RFS)in patients with DCIS were observed through the survival curve.Results:(1)There were no statistically significant differences in the first symptoms,lymph node status,surgical method,and P53 protein expression between the pure-DCIS and DCIS-COL groups(all P>0.05).There were statistically significant differences in the expression of ER,PR,HER-2,Ki-67 and nuclear grade,age,menstrual status,and tumor maximum diameter between the two groups(P<0.05).(2)Binary Logistic regression analysis showed that Ki-67≥14%was an independent risk factor for COL in DCIS(P=0.031,OR=2.670,95%CI 1.094 to6.518).(3)Kaplan-Meier analysis found that COL,age,menstrual status,Ki-67expression,tumor maximum diameter,lymph node status,and pathological nuclear grade were risk factors for RFS after surgery(All P values are<0.05).The 5-year RFS of pure-DCIS is 96.08%,and the 5-year RFS of DCIS-COL is 89.22%.Conclusions:(1)There are differences in the clinical characteristics and molecular expression of pure-DCIS and DCIS-COL.(2)Ki-67 overexpression is an independent risk factor for COL in DCIS.(3)COL,age<50 years,non-menopausal,Ki-67≥14%,tumor size>2cm,preoperative lymph node metastasis,and pathological high nuclear grade are risk factors for recurrence and metastasis after DCIS surgery.