Đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị ung thư vú thể dị sản tại Bệnh viện K

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Khánh Toàn Phan, Thị Huyền Phùng, Lê Huy Trịnh

Ngôn ngữ: vie

Ký hiệu phân loại: 616.4 Diseases of hematopoietic, lymphatic, glandular systems Diseases of endocrine system

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 166-170

Bộ sưu tập: Metadata

ID: 502523

Thêm vào giỏ

Chúng tôi đánh giá các đặc điểm lâm sàng, cận lâm sàng, đồng thời phân tích thời gian sống thêm không bệnh (DFS) và các yếu tố ảnh hưởng ở bệnh nhân ung thư vú thể dị sản (MBC). Phương pháp: Nghiên cứu mô tả hồi cứu kết hợp tiến cứu được thực hiện trên bệnh nhân MBC giai đoạn I - III tại bệnh viện K cơ sở 3 từ tháng 1 năm 2017 đến tháng 2 năm 2023. Kết quả: Trong 92 bệnh nhân MBC tham gia nghiên cứu, 32 bệnh nhân (34,8%) có di căn hạch và kích thước u trung bình là 3,56 ± 0,21 cm tại thời điểm chẩn đoán. Ngoài ra, 62 bệnh nhân (66,3%) được chẩn đoán ở giai đoạn II, theo sau là 17 bệnh nhân (18,5%) ở giai đoạn III, và 14 bệnh nhân (15,2%) ở giai đoạn I. Chỉ 15,2% và 27,2% bệnh nhân tương ứng có đặc điểm điển hình của ung thư vú (UTV) trên X quang tuyến vú và siêu âm vú. Về đặc điểm hoá mô miễn dịch (HMMD), đa số các bệnh nhân có đặc điểm của UTV bộ ba âm tính, chiếm 71,7% bệnh nhân. DFS sau 2 năm và 3 năm lần lượt là 77,7% và 73,8%. Phân tích đơn biến chỉ ra kích thước khối u, tình trạng di căn hạch, giai đoạn tại thời điểm chẩn đoán và điều trị hoá chất bổ trước hay phẫu thuật ngay là yếu tố tiên lượng của MBC. Tuy nhiên, chỉ kích thước khối u là yếu tố có ý nghĩa khi dự đoán DFS với p=0,028 qua phân tích đa biến. Kết luận: MBC được chứng minh là thể bệnh tiến triển nhanh, tiên lượng xấu và thường có đặc điểm không điển hình trên các chẩn đoán hình ảnh thường quy. Hiện nay, các phương pháp điều trị tiêu chuẩn cho UTV ít hiệu quả trên nhóm bệnh nhân này. Vì vậy, nghiên cứu tìm ra các hướng điều trị mới cho MBC là thực sự cần thiết.We evaluated the clinicopathological characteristics of metaplastic breast cancer (MBC), a rare entity of breast malignancy, along with disease-free survival and prognosis factors. Methods: A retrospective study was conducted on patients with stage I-III MBC at the Vietnam National Cancer Hospital from January 2017 to February 2023. Results: Of the 92 patients, 32 patients (34,8%) had clinical lymph node involvement and the median primary tumor size of 3,56 ± 0,21 cm. 62 patients (66,3%) were diagnosed with stage II, followed by 17 patients (18.5%) with stage III, and 14 patients (15,2%) with stage I. Only 15,2% and 27,2% cases had showed typical features of breast cancer on mammography and ultrasound, respectively. On immunohistology, the majority was triple negative breast cancer, accounting for 71,7%. The two- and three-year disease-free survival (DFS) rate was 77,7% and 73,8% respectively. Univariable analysis showed that tumor size, lymph node metastasis, stage at diagnosis, neoadjuvant and adjuvant chemotherapy were associated with survival of patients with MBC. However, only tumor size was an independent predictor of three-year DFS with a p-value of 0,028 on multivariable analysis. Conclusions: MBC demonstrated early disease progression and poor DFS with atypical presentation on routine imaging. Current standard treatments are ineffective, highlighting the urgent need for research to identify innovative therapeutic strategies for MBC patients.

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