不同分子亚型双侧原发性乳腺癌临床分析

目的 探讨双侧原发性乳腺癌(BPBC)各分子亚型的临床病理特征及预后.方法 回顾性分析116例BPBC患者的临床资料,分析各分子亚型BPBC的临床病理特征、临床预后情况及第一癌与第二癌间各分子亚型的一致性.结果 (1)检出第一癌Luminal A型65例,Luminal B型17例,HER-2过表达型13例,TNBC型21例；第二癌Luminal A型67例,Luminal B型15例,HER-2过表达型10例,TNBC型24例.BPBC第一癌与第二癌在分子亚型上具有良好的一致性.(2)肿瘤大小、肿瘤组织学分级各亚型间比较均有显著性差异(P＜ 0.05).(3)各分子亚型的生存率比较均无明显差异(P＞ 0.05)；TNBC型5年无病生存率显著低于其他各分子亚型(P＜0.01).结论 第一癌发病年龄早、肿瘤直径大、病理组织学高分级和TNBC分子亚型是BPBC发病及预后的重要预测指标.

Clinical features of bilateral primary breast cancer by molecular subtypes

Objective To analyze the clinical pathological features and prognosis of bilateral primary breast cancer （BPBC） by molecular subtypes. Methods Clinical data of 116 BPBC patients were reviewed focusing on the clinico- pathological features and prognosis of different molecular subtypes, and analyzed the concordance of molecular subtype between first and second primary breast cancer. Results （1）In first primary breast cancers, Luminal A subtype in 65 cases, Luminal B subtype in 17 cases, HER-2 subtype in 13 cases, TNBC subtype in 21 cases. In the second breast cancers, Luminal A subtype in 67 cases, Luminal B subtype in 15 cases, HER-2 subtype in 10 cases and TNBC sub- type in 24 cases. The first cancer and the second cancer had good consistency in different molecular subtypes of BP- BC. （2）The size and histological grading of tumor had significant difference in different molecular subtypes of BPBC （P 〈 0.05）. （3）The survival rate had no significant difference in different molecular subtypes of BPBC （P 〉 0.05）, but the five-year disease-free survival rates of TNBC subtype were significant lower than other groups （P 〈 0.01）. Conclu- sion An early onset of the first cancer, larger diameter of the tumor, higher histologically grade and TNBC molecular subtype are the important predictors of etiology and prognosis of BPBC.