单一激素受体阳性浸润性Luminal A亚型乳腺癌的临床分析

目的研究单一激素受体阳性Luminal A亚型浸润性乳腺癌的临床特点和生存状况,探讨其个体化综合治疗的理论基础。方法回顾性分析首都医科大学附属北京友谊医院2002年1月至2013年6月收治的乳腺癌患者病例,选择接受手术治疗、资料完整,经免疫组化方法能明确判定为单一激素受体阳性的浸润性Luminal A亚型乳腺癌的患者94例进行分析,对其临床特征、复发及生存情况进行分析。结果中位随访时间47.0个月(6~77个月),出现局部复发或远处转移13例(13.8%),包括局部复发1例(1.1%),远处转移11例(11.7%),及局部复发合并远处转移1例(1.1%)。总的无病生存率为77.2%,9例患者死亡(9.6%),总生存率为80.1%。Kaplen-Meier生存分析显示,脉管瘤栓和临床分期是影响总生存时间的因素(P0.05);淋巴结状况、脉管瘤栓和临床分期影响患者无病生存时间(P0.05)。多因素分析显示,脉管瘤栓是总生存时间(OR=0.167,95%CI:0.031-0.900,P0.05)及无病生存时间(OR=0.069,95%CI:0.007-0.697,P0.05)的独立影响因素。结论脉管瘤栓是单一激素受体阳性的浸润性Luminal A亚型乳腺癌局部复发和生存时间的独立影响因素,此研究结果有待于进一步论证。

Clinical analysis of uni - hormonal receptor positive invasive lunimal A subtype breast cancer

Objective HER -2 negative, estrogen receptor（ER） and/or progesterone receptor （PR） positive breast cancer is defined as Luminal A subtype breast cancer clinically. This study was to analyze clinical characteristics of uni -hormonal receptor （ER or PR） positive breast cancers of invasive Luminal A subtype, and try to find the evidence of combined and individualized treatment for patients with this type breast cancer. Methods The 94 cases of Luminal A subtype breast cancer patients with positive uni -hormonal receptor, who received operation in Beijing Friendship Hospital, Capital Medical University, from January in 2002 to June in 2013, were collected and the clinical characteristics, recurrences, metastasis and survivals were retrospectively analyzed. Results With 47.0 months （range, 6 - 77 months） follow - up, 13 cases （ 13.8% ） presented local recurrence or metastasis including 11 cases with metastasis （11.7%）, 1 cases local recurrences （1.1%） and 1 case with both local recurrence and metastasis （1.1%）; the rate of disease - free survival （DFS） was 77.2%. 9 patients （ 9. 6% ） died of breast cancer, and the rate of overall survival （OS） was 80.1%. According to Kaplen - Meier survival analysis, lymph vascular invasion （LVI） and clinical stage were correlated to overall survival time （P 〈 0.05） ; and lymph node status, LVI and clinical stage were correlated to disease - free survival time （ P 〈 0. 05 ）. Multivariate analysis were conducted, LVI was independent prognosis factor correlated to overall survival time （OR =0.167, 95%CI： 0.031 -0.900, P 〈0.05） and to disease -free survival time（OR =0.069, 95% CI： 0.007 -0.697, P 〈0.05）. Conclusion In uni -hormonal receptor positive invasive breast cancers of Luminal A subtype, LVI is correlated to recurrence, metastasis and survival time. Further studies are needed to confirm our findings.