| Objective:Through retrospective analysis of the clinicopathological features,molecular typing and proportion of each subtype of IDC-MPD and IDC,the differences between IDC-MPD and IDC in clinicopathological features and molecular subtypes were discussed,hoping to provide new basis and ideas for individualized and standardized treatment of IDC-MPD.Methods:A retrospective analysis was performed on the breast surgery department of China-Japan Friendship Hospital of Jilin University from July 2012 to September2018 after systematic diagnosis and treatment,postoperative paraffin pathology revealed 50 patients with MPD,among which 3 had received preoperative neoadjuvant chemotherapy,1 had simple MPD without potential cancer foci,10 had DCIS-MPD,and finally 36 IDC-MPD patients were included in the study group.At the same time,50 patients with invasive ductal carcinoma were randomly selected as the control group after systematic treatment in our hospital.To analyze the clinicopathological features of IDC-MPD and IDC and the differences between them.To explore the molecular typing of IDC-MPD and the proportion of each subtype,as well as the differences between IDC-MPD and IDC molecular typing.Result:1.The age range of patients in the IDC-MPD group was between 32 and 72 years,with an average age of 53.3 years.Premenopausal women accounted for 41.67% and postmenopausal women accounted for 58.33%.Patients in the IDC group ranged in age from 37 to 67 years old,with an average age of 51.92 years old.Premenopausal women accounted for 44.00% and postmenopausal women accounted for 56.00%.There was little difference in age of onset and menstrual status between the two groups.2.The majority of invasive duct carcinomas associated with MPD were located in the nipple and areola area(58.33%),a small part in the outer upper quadrant of the breast(25.00%),and some cases were located in other quadrants of the breast.In the IDC group,most of the lesions were located in the upper,lower,upper and other peripheral quadrants of the breast,and only 12% were located in the nipple and areola area.There was a statistical difference in the lesion location between the two groups.3.The clinical manifestations of the IDC-MPD group included 12 cases of nipple rupture,22 cases of breast lump and 2 cases of nipple discharge.The clinical manifestations of 50 cases in IDC group were breast mass.4.The disease course of the IDC-MPD group ranged from 2 days to 10 years,with an average course of 15.03 months;The disease course of IDC group ranged from 1 day to 10 years,with an average course of 4.26 months.There was a statistical difference in disease course(P<0.05).5.There was a statistical difference between the IDCMPD group and the IDC group in whether or not they had diabetes,P<0.05,and the IDC group had more diabetes.There was also a statistical difference in BMI between the two groups,with P<0.05.Most of the patients in the IDC-MPD group were in the normal group,while most of the patients in the IDC group were in the overweight and obese group.6.IDC-MPD group of patients with histological grading Ⅰ level 0patients with MPD group,Ⅱ level 16 cases(44.44%),grade Ⅲ 20 cases(55.56%).IDC group of patients with histological grading Ⅰ level 1 case(2.00%),grade Ⅱ 29 cases(58.00%),grade Ⅲ 20 cases(40.00%).7.IDC-MPD group of patients clinical TNM staging,Ⅰ period 15 cases(41.67%),Ⅱ period 15 cases(41.67%),Ⅲ period 6 cases(16.66%).IDC group of patients clinical TNM staging,Ⅰperiod 18 cases(36.00%),Ⅱ 23 cases(46.00%),Ⅲ 9 cases(18.00%).8.There were27 cases(75.00%)with negative ER and 9 cases(25.00%)with positive ER in the IDC-MPD group.PR was negative in 25 cases(69.44%)and positive in 11 cases(30.56%).Ki67 expression was low in 7 cases(19.44%)and high in 29 cases(80.56%).In IDC group,there were 6 cases(12.00%)with negative ER and 44 cases(88.00%)with positive ER.PR was negative in 8 cases(16.00%)and positive in 42cases(84.00%).There were 24 cases with low Ki67 expression(48.00%)and 26 cases with high Ki67 expression(52.00%).There was a statistical difference in Ki67 expression between the two groups(P<0.05).9.The molecular typing of IDC-MPD group was mainly HER-2 positive(HR negative),followed by HER-2 positive(HR positive),while the triple negative type and Luminal type were very rare.The molecular typing of IDC was mainly Luminal type(accounting for 80% of the total),while the tri-negative type,HER-2 positive(HR negative)and HER-2 positive(HR positive)were rare.There was a statistical difference in molecular typing between the two groups(P<0.05).10.In the analysis of the influence of IDC-MPD clinicopathological features on TNM stage,there were statistical differences in tumor size and disease course(P<0.05).When the tumor was larger than 2cm and the disease course was more than 24 months,the TNM stage was higher.In the IDC group,there were statistically significant differences in tumor size and Ki67.When the tumorsize was larger than 2cm and the expression of Ki67 was high,the TNM stage was higher.Conclusion:1.The age of onset and menstrual status of IDC-MPD and IDC were not significantly different.2.Most of the clinical manifestations of IDC-MPD were breast lumps,with only 12 cases(33.33%)with typical clinical features of MPD,and 4 cases(11.11%)with inverted nipples.3.The disease course of IDC-MPD group was about11 months longer than that of IDC group.When the disease course was longer than 24 months,TNM stage was higher.4.Compared with IDC-MPD,IDC group had more diabetes.Most of the patients in the IDC-MPD group were in the normal group,while most of the patients in the IDC group were in the overweight and obese group.5.The majority of patients in the IDC-MPD group(80.56%)had high Ki67 expression,while the IDC group had roughly the same number of patients with high and low Ki67 expression.6.The molecular subtyping of IDC-MPD was mainly HER-2 positive(HR negative),followed by HER-2 positive(HR positive),while the three negative types and Luminal types were very rare.The molecular typing of IDC was mainly Luminal type(accounting for 80% of all),while the tri-negative type,HER-2 positive(HR negative)and HER-2 positive(HR positive)were rare. |
