摘要目的 探讨乳腺梭形细胞癌的临床病理特征、诊治要点和预后.方法 回顾性分析2004-2013年确诊的20例乳腺梭形细胞癌患者的临床资料,应用Kaplan-Meier法计算生存率并绘制生存曲线.结果 全组患者均为女性,中位发病年龄为54岁,首发症状均为乳腺肿物,肿瘤平均最大直径3.8 cm.术前钼钯、超声和空芯针活检误诊率高,主要诊断依据为术后石蜡病理组织检查.免疫组化结果显示,雌激素受体、孕激素受体和人类表皮生长因子受体2阳性表达率低,Ki-67表达率为68.8％,表皮生长因子受体(EGFR)阳性率为63.6％.20例患者的中位随访时间为32个月,3年生存率和3年无病生存率分别为80.6％和57.2％.结论 乳腺梭形细胞癌较罕见,预后较差.激素受体阳性率低,Ki-67呈高表达,EGFR表达率较高.乳腺梭形细胞癌侵袭性强,以根治性手术为主的综合治疗是其最佳治疗方式.

abstractsObjective To investigate the clinical features,appropriate diagnosis and prognosis of spindle cell carcinoma of the breast (SpCC).Methods Clinicopathological data of 20 patients with histopathologically confirmed breast SpCC treated in Tianjin Cancer Hospital from 2004 to 2013 were reviewed retrospectively.The survival rate was calculated by Kaplan-Meier analysis.Results All the patients were female and their median age was 54 years.The median maximum diameter of the tumor was 3.8 cm.The misdiagnosis rate was high by mammography,B-ultrasound and core needle biopsy (CNB) before operation.So that the diagnosis primarily depended on postoperative histopathological examination.The positive expression rate of estrogen receptor(ER),progesterone receptor(PR) and human-epidermal growth factor receptor-2 (HER-2) was low.The over-expression rate of Ki-67 was 68.8％.The positive expression rate of EGFR was 63.6％.The median follow-up time of the 20 patients was 32 months and their 3-year overall survival rate and 3-year disease-free survival rate were 80.6％ and 57.2％,respectively.Conclusions Spindle cell carcinoma of the breast is rare and has a poor prognosis.The expressions of ER,PR and HER-2 in most samples are negative,Ki-67 is overexpressed,and positive rate of EGFR is high.This disease is highly invasive,and the best treatment modality is comprehensive therapy mainly based on radical resection.