Prognosis Of Invasive Papillary Carcinoma And Analysis Of Related Factors

BackgroundWorldwide,breast cancer has become one of the most important malignant tumors that harm women's health.The incidence of breast cancer in the world has been continuously increasing since the end of the 1970s.According to data from the National Cancer Center,one out of eight women in the United States has breast cancer.According to the statistics released by the International Cancer Research Center in 2012,there are 1.7 million new cases of female breast cancer diagnosed each year in the world,accounting for 25%of the total incidence of female malignant tumors,including 521,900 deaths,which account for the deaths of all female malignant tumors.15%^[1].Although China is not a high-risk country for breast cancer,the actual situation is equally unpleasant.In the past 10 years,the growth rate of breast cancer in our country is about 1 to 2 percentage points higher than that in high-incidence countries,and it has been increasing year by year.It ranks first in the incidence of female malignant tumors in China,the mortality rate ranks fourth,and its mortality rate has increased by 99.99%in the past 30 years^[2],and it has gradually become an important disease that threatens the health of women in China and the world at large.There are many high-risk factors for breast cancer,such as the change of dietary lifestyle,the deterioration of the surrounding environment and so on,which are the factors that cause the rising incidence of breast cancer in China.With the deepening of breast cancer research,clinicians have gradually realized that breast cancer is highly heterogeneous.Although a single anatomical stage can predict the risk of recurrence and provide treatment decisions,it does not fully reflect the biology of breast cancer.behavior.In particular,the focus of research on breast cancer in recent years has gradually focused on the immunohistochemistry and molecular aspects.Some special types of breast cancer have gradually attracted the attention and attention of pathologists and clinicians.Among them,invasive micropapillary carcinoma?IMPC?is a special type of breast cancer,although the incidence is very low,accounting for about 2.0%to 6.0%of the incidence of breast cancer^[3-4].Because of its early lymphatic invasion,high lymph node metastasis,and poor prognosis,and the combination of multiple IMPC and other types of breast cancer,it is easy to miss the diagnosis and misdiagnosis.At present,research focuses on IMPC at home and abroad mainly focus on clinical pathological analysis,immunohistochemistry and other aspects.There are few studies on the prognosis and related factors of IMPC.Therefore,the main purpose of this study was to improve the understanding of invasive micropapillary carcinoma by collecting,summarizing,collating and summarizing the data of 50 patients with IMPC in our breast department,and to analyze the relationship between clinical characteristics and prognosis of IMPC.Provide clinical evidence for clinical follow-up diagnosis and treatment.ObjectBy collecting and analyzing clinical data of IMPCs with different proportions of IMPC components,comparing the clinical features and differences of different proportions of IMPCs provide evidence for the diagnosis of IMPC.By collecting the pathological data and follow-up information of IMPC,the factors affecting lymph node metastasis and prognosis were analyzed to provide evidence-based medical evidence for clinical diagnosis and treatment.Materials and Methods1.To collect 50 cases of IMPC patients who were treated and treated in our hospital from January 2007 to December 2014 in the Breast Department of the Third Affiliated Hospital of Zhengzhou University.The main data collected were:age of 50patients,tumor diameter,menopausal status,recurrence,proportion of IMPC components,histological grade,estrogen receptor,progesterone receptor,human epidermal growth factor receptor 2 and cells.Proliferation antigen?Ki67?,surgical method.2.Follow-up methods are mainly out-patient review or telephone follow-up.Follow-up time was from the date of surgery to the last follow-up period.The observation period was December 31,2016 and the follow-up period was 11 to 119months.And record the local recurrence of disease,distant metastasis,death and other conditions.3.Statistical software uses SPSS21.0 statistical software for analysis.Differences between groups with different proportions of IMPC were compared using the X² test or Fisher's exact test;Logistic regression analysis was used to analyze the risk factors associated with lymph node metastasis;Kaplan-Meier method was used to calculate survival rate;Log-rank test was used for single factor prognosis.Analysis,COX proportional hazards regression model for survival time-related multi-factor analysis.P<0.05 difference was statistically significant.Results1.Comparing the clinicopatholocal characters of three groups of IMPCs with different proportions of IMPC,according to the patient's age,menopausal status,tumor size,HER-2 amplification and positive expression,Ki67 high and low expression,ER,PR,lymph node metastasis,etc.Grouping.There was no significant difference in age,menopause,tumor size,HER-2 amplification and positive expression status,Ki67 expression,ER,PR,and lymph node metastasis in the three groups.There was no statistical significance?P>0.05?.2.Analysis of risk factors for lymph node metastasis revealed that histological grade,expression of Ki-67 was associated with lymph node metastasis?P<0.05?,age of the patient at the time of diagnosis,menstrual status,status of PR,ER,Her-2,and IMPC The proportion of components was not related to lymph node metastasis?P>0.05?.3.IMPC had a 3-year overall survival rate?91.7%?and a 5-year overall survival rate?67.2%?.Univariate analysis revealed that tumor diameter,histological grade,and lymph node metastasis were related to the prognosis of IMPC.Multivariate analysis showed that primary tumor diameter,histological grade,and lymph node metastasis were not independent prognostic factors for patient survival.ConclusionThere was no difference in the distribution of clinicopathological characteristics between IMPCs with different proportions of micropapillary carcinomas.As long as the components of microvessel papillary cancer in the cancer nest are diagnosed as IMPC.IMPC has the features of strong lymphatic invasion and high lymph node metastasis.The high risk factors for lymph node metastasis are histological grade and high expression of Ki-67.The prognosis of IMPC is inconclusive.It is not clinically feasible to evaluate its prognosis simply based on a single index.It is necessary to fully consider the tumor characteristics?such as tumor specificity and atypicality?of IMPC itself and comprehensively evaluate the prognosis of IMPC.