子宫体、乳腺双原发癌的临床病理特征

doi:10.3969/j.issn.1006-7795.2019.06.010

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (6): 857-862.doi: 10.3969/j.issn.1006-7795.2019.06.010

子宫体、乳腺双原发癌的临床病理特征

王维¹, 张紫寒², 翟妍³, 桑翠琴³, 王淑珍³

1. 北京市房山区妇幼保健院妇产科, 北京 102488;
2. 北京协和医院妇科, 北京 100005;
3. 首都医科大学附属北京朝阳医院妇产科, 北京 100020

收稿日期:2019-09-23 出版日期:2019-11-21 发布日期:2019-12-18
通讯作者: 王淑珍 E-mail:darrywang2003@163.com
基金资助:
首都市民健康培育项目（161100000116077），北京市医管局扬帆计划重点项目（ZYLX201713）。

Clinical characteristics of the double primary malignant tumors of uterine corpus/breast

Wang Wei¹, Zhang Zihan², Zhai Yan³, Sang Cuiqin³, Wang Shuzhen³

1. Department of Obstetrics and Gynecology, Beijing Fangshan Maternal and Child Health Hospital, Beijing 102488, China;
2. Department of Gynecology, Peking Union Medical College Hospital, Beijing 100005, China;
3. Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China

Received:2019-09-23 Online:2019-11-21 Published:2019-12-18
Supported by:
This study was supported by Capital Citizen Health Cultivation Project(161100000116077),Key Projects of Sailing Plan of Beijing Medical Administration(ZYLX201713).

摘要/Abstract

摘要： 目的探讨子宫体、乳腺双原发癌的临床病理特征。方法回顾性分析首都医科大学附属北京朝阳医院2004年1月至2015年1月收治子宫体、乳腺双原发癌患者（双癌组）29例和子宫体恶性肿瘤患者（单癌组）319例的临床病理资料。结果双癌组合并糖尿病（χ²=8.02，P=0.007）、肿瘤家族史（χ²=31.76，P<0.001）及其他部位恶性肿瘤（χ²=31.76，P<0.001）的比例显著高于单癌组，双癌组Ⅱ型子宫体恶性肿瘤（χ²=5.52，P=0.030）及低分化癌（χ²=8.39，P=0.020）的构成比明显高于单癌组。单癌组的总生存率（overall survival，OS）明显优于双癌组（Log-rank=6.75，P=0.011）。分层分析显示，在双癌组中，首发子宫体癌的双癌患者Ⅱ型子宫内膜癌的构成比明显高于首发乳腺癌组（58.33%vs 11.76%，χ²=6.882，P=0.014）。首发子宫体癌与首发乳腺癌的两癌发病间隔时间显著不同，前者的间隔时间明显缩短（t=2.23，P=0.028）。两组双原发癌间隔时间的分布差异有统计学意义（χ²=9.60，P=0.010）。结论合并乳腺癌的子宫体恶性肿瘤与子宫体恶性肿瘤的临床、病理特征不同。乳腺癌后子宫体恶性肿瘤与子宫体恶性肿瘤术后发生乳腺癌的临床、病理特征不同。

关键词: 子宫体恶性肿瘤, 乳腺癌, 生存分析, 预后

Abstract: Objective To investigate the clinical and pathological characteristics of the double primary malignant tumors of uterine corpus/breast. Methods A case-control study was performed for the clinical and pathological data of 29 patients with primary malignant uterine tumor and breast cancer (double cancers group) and 319 patients with only endometrial malignancy (single cancer group) who had visited Beijing Chaoyang Hospital during January 2004 to January 2015. Results Double cancers group showed a significantly higher percentage of patients with diabetes(χ²=8.02,P=0.007),family history of cancer(χ²=31.76,P<0.001),with other primary tumor(χ²=31.76,P<0.001),and type Ⅱ endometrial carcinoma(χ²=5.52,P=0.030) and poorly-differentiated cancer tissue (χ²=8.39,P=0.02)compared with endometrial malignant group. Endometrial cancer group had a significantly better overall survival compared with double cancers group (Log-rank=6.75,P=0.011). Stratified analysis showed that the group of double cancers with primary endometrial malignancy showed a significantly higher percentage of patients with type Ⅱ endometrial carcinoma (58.33% vs 11.76%) than that with primary breast cancer, with a significantly shorter interval between the two tumors (t=2.23,P=0.028). Conclusion The clinical and pathological characteristics of endometrial malignancy with primary breast cancer is different from that of only endometrial malignancy. The clinical and pathological characteristics of breast cancer with primary malignant uterine tumor is different from that of endometrial malignant with primary breast cancer.

Key words: endometrial malignant, breast cancer, survival analysis, prognosis

中图分类号:

R737.3

王维, 张紫寒, 翟妍, 桑翠琴, 王淑珍. 子宫体、乳腺双原发癌的临床病理特征[J]. 首都医科大学学报, 2019, 40(6): 857-862.

Wang Wei, Zhang Zihan, Zhai Yan, Sang Cuiqin, Wang Shuzhen. Clinical characteristics of the double primary malignant tumors of uterine corpus/breast[J]. Journal of Capital Medical University, 2019, 40(6): 857-862.

参考文献

[1] 黄育北, 佟仲生, 陈可欣, 等. 《中国女性乳腺癌筛查指南》解读(精简版)[J]. 中国肿瘤临床, 2019,46(9):432-440.
[2] Grzankowski K S, Szender J B, Spring-Robinson C L, et al. Evaluation of metachronous breast and endometrial cancers before and after routine adjuvant tamoxifen usage[J]. Gynecol Oncol, 2016, 141(1):129-130.
[3] Warren S,Gates O. Multiple primary malignant tumors. A survey of the literature and a statistical study[J]. Am J Cancer 1932,16:1358-1414.
[4] Shinohara M,Matsuura Y,Baba S,et al. Multiple primary cancers associated with gynecologic malignancies[J]. Nihon Sanka Fujinka Gakkai Zasshi,1990,42(6):561-566.
[5] Petrucci M S,Bianconi F,Dolciami F,et al. Multiple primary cancers in women with gynaecological malignancies:a cancer registry-based study in Umbria region of Italy[J]. Eur J Gynaecol Oncol,2014,35(6):631-634.
[6] Schonfeld S J,De Gonzalez A B,Visvanathan K,et al. Declining second primary ovarian cancer after first primary breast cancer[J]. J Clin Oncol,2013,31(6):738-743.
[7] Siegel R L,Miller K D,Jemal A. Cancer statistics,2019[J]. CA Cancer J Clin,2019,69(1):7-34.
[8] Molina-Montes E,Requena M,Sánchez-Cantalejo E,et al. Risk of second cancers cancer after a first primary breast cancer:a systematic review and meta-analysis[J]. Gynecol Oncol,2015,136(1):158-171.
[9] Shu C A,Pike M C,Jotwani A R,et al. Uterine cancer after risk-reducing salpingo-oophorectomy without hysterectomy in women with BRCA mutations[J]. JAMA Oncol,2016,2(11):1434-1440.
[10] Nair N,Schwartz M,Guzzardi L,et al. Hysterectomy at the time of risk-reducing surgery in BRCA carriers[J]. Gynecol Oncol Rep,2018,26:71-74.
[11] Long B,Lilyquist J,Weaver A,et al. Cancer susceptibility gene mutations in type I and Ⅱ endometrial cancer[J]. Gynecol Oncol,2019,152(1):20-25.
[12] Bani-Mostafavi E S,Tayebi S,Tayebi M,et al. Case report:synchronous primary malignancy including the breast and endometrium[J]. Version 3 F1000Res,2017,6:1502.
[13] Ngô C,Brugier C,Plancher C,et al. Clinico-pathology and prognosis of endometrial cancer in patients previously treated for breast cancer,with or without tamoxifen:A comparative study in 363 patients[J]. Eur J Surg Oncol,2014,40(10):1237-1244.
[14] Matsuo K, Mandelbaum R S, Machida H,et al. Decreasing secondary primary uterine cancer after breast cancer:A population-based analysis[J]. Gynecol Oncol,2019,154:169-176.
[15] 刘晨,刘军,王淑珍,等.乳腺癌术后并发妇科生殖道恶性肿瘤的高危因素分析[J].首都医科大学学报,2017,38(1):92-96.
[16] Garg K,Karnezis A N,Rabban J T. Uncommon hereditary gynaecological tumour syndromes:Pathological features in tumours that may predict risk for a germline mutation[J]. Pathology,2018,50(2):238-256.
[17] Zhang J, Li L, Lu Y. Suppression of hypoxia/HIF-1° promoted breast cancer malignant progression by p16/INK4a[J].Mol Ther,2014,22:169.
[18] Kim H Y, Ha Thi H T,Suntaek Hongg. IMP2 and IMP3 cooperate to promote the metastasis of triple-negative breast cancer through destabilization of progesterone receptor[J].Cancer Lett,2018,415:30-39.
[19] Samanta S,Guru S, Elaimy A L,et al. Mercurio.IMP3 stabilization of WNT5B mRNA facilitates TAZ activation in breast cancer[J].Cell Rep,2018,23(9):2559-2567.

子宫体、乳腺双原发癌的临床病理特征

Clinical characteristics of the double primary malignant tumors of uterine corpus/breast

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