The Relationship Between Micropapillary Carcinoma Component Ratio And The Prognosis Of Patients With Invasive Micropapillary Breast Carcinoma

Background:Breast carcinoma is one of the most important malignant tumors affecting women's health in the worldwide,accounting for about 23% of the incidence of female malignant tumors.In China,the incidence of breast cancer has exceeded that of lung cancer,ranking the first place in the incidence of female malignant tumors and the second place in the mortality of female malignant tumors.As a special type of breast carcinoma,invasive micropapillary carcinoma of breast(IMPC)has been gradually understood by doctors in the continuous research on breast carcinoma.IMPC incidence is low,accounting for about 2%-8% of invasive breast cancer,but it has high local recurrence and metastasis rate,lymph node metastasis rate and lymphovascular invasion,poor prognosis and other characteristics,but there are few studies at home and abroad on IMPC prognostic factors and the proportion of components of micro papillary carcinoma in breast cancer.At present,the related factors used to determine the prognosis of breast cancer mainly include disease stage,tumor markers,molecular typing and genetic testing.IMPC has no specific prognostic index for IMPC.To improve the survival time,prognosis and quality of life of IMPC patients.ObjectivesTo explore the correlation between the proportion of micropapillary components and clinicopathological factors,and the relationship between the proportion of micropapillary components and the prognosis of IMPC,to figure out the risk factors associated with poor prognosis,and to guide clinical timely assessment and develop more effective therapies.MethodsThe study conclude 58 patients who were diagnosed by pathology in Qing Dao Municipal Hospital and the affiliated hospital of Qingdao university from January 2007 to December 2012.These patients' pathological diagnosis is either IMPC or contains micropapillary carcinoma(MC)composition.Collecting the data of these patients,including their tumor diameter,clinicopathologic information like ER,PR,Her-2,Ki-67,molecular subtype,the number of lymph node metastasis,whether there is Lymphovascular invasion(LVI),treatment,and patients' age,sex,stage and other data.The survival and the time of metastasis of the patients were obtained by telephone follow up or case review.The relationship between each clinicopathological factor and the micropapillary components was analyzed,as well as the relationship between the above factors and the prognosis of IMPC patients.SPSS statistical 24.0 software was used for data analysis.Chi-square test or Fisher's exact test was used for disordered variables.Kaplan-meier method was used for univariate survival analysis and Log rank test was used for comparative survival curve.Multivariate survival analysis uses Cox risk regression model.P < 0.05 is considered as statistically significant for all parameters.ResultsThis study retrospectively analyzed the clinical data of 58 patients with breast cancer and divided them into two groups according to the ratio of MC: group 1 had a MC ratio of 10%-75%,a total of 17 cases;group 2 had a MC ratio of more than 75%,a total of 41 cases.The chi-square test was used to compare the relationship between the clinicopathological factors of the patients and the micropapillary components,the results showed that there was no statistical significance between the expression of ER,PR and her-2 and the proportion of MC components(P<0.05).Kaplan-meier univariate survival analysis suggested that disease-free survival(DFS)of the patients was related to the expressions of ER,PR and Her-2,the ratio of micropapillary components,LVI,and the number of lymph node metastases(P<0.05).COX multivariate survival analysis showed that the expressions of ER,PR and Her-2,LVI,and the number of lymph node metastases were not independent prognostic factors for disease-free survival(DFS)(P>0.05),while the proportion of micropapillary components was independent prognostic factors for disease-free survival(P<0.05).Conclusions1.There was no correlation between the expression of ER,PR,her-2 and MC components.2.Disease-free survival(DFS)of patients was correlated with the expressions of ER,PR and Her-2,the proportion of micropapillary components,LVI,and the number of lymph node metastases.3.The proportion of micropapillary components is an independent prognostic factor for disease-free survival of patients.The expressions of ER,PR and her-2,the presence or absence of LVI,and the number of lymph node metastases have no correlation with them.