新疆地区1006例不同分子分型乳腺癌的临床病理特征及预后

目的 探讨新疆地区不同分子分型乳腺癌的临床病理特征和预后。方法 收集2008年1月至2010年12月新疆医科大学附属肿瘤医院行手术治疗的1006例女性乳腺癌患者的临床病历资料，根据雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体-2（HER-2）和Ki-67的状态，将乳腺癌分为：Luminal A型、Luminal B型、HER-2过表达型及Basal like型，对比分析不同分子分型乳腺癌患者的临床病理特征、复发转移及预后情况。结果 Luminal A型551例（54.8％），Luminal B型182例（18.1％），HER-2过表达型77例（7.7％），Basal-like型196例（19.4％）。不同分子分型乳腺癌在肿块大小、淋巴结转移数目、临床分期、组织学分级、民族及内分泌治疗的差异均具有统计学意义（P＜0.05）。获得随访的971例患者中，HER-2过表达型的局部复发率（12.3％）及远处转移率（27.4％）均高于其他分型（P＜0.05）。Luminal A型、Luminal B型、HER-2过表达型及Basal-like型6年无病生存率分别为86.8％、75.8％、58.9％、79.1％（P＜0.05）；6年生存率分别为92.1％、83.1％、67.1％、88.0％（P＜0.05）。Cox多因素回归分析显示，淋巴结转移数目、组织学分级、内分泌治疗及分子分型是影响新疆地区乳腺癌总生存时间（OS）和无病生存时间（DFS）的独立因素，民族亦是影响该地区乳腺癌患者DFS的独立因素。结论 新疆地区Luminal A型乳腺癌最常见，预后最好，HER-2过表达型比例最低，预后最差。乳腺癌预后与淋巴结转移数目、组织学分级、内分泌治疗及分子分型有关，民族是影响乳腺癌患者DFS的重要因素。

Clinicopathological characteristics and prognosis analysis among 1006 cases of different molecular subtypes of breast cancer in Xinjiang

Objective To investigate the clinicopathological characteristics and prognosis among different molecular subtypes of breast cancer in Xinjiang. Methods Clinicopathological characteristics of 1006 cases of operable female breast cancer at Xinjiang Tumor Hospital between January 2008 and December 2010 were analyzed retrospectively. According to status of ER， PR， HER-2 and Ki 67, breast cancer patients were divided into Luminal A subtype, Luminal B subtype， HER-2 subtype and Basal-like subtype. The clinical features and prognosis among different molecular subtypes breast cancer were analyzed. ResultsOut of the 1006 cases， Luminal A subtype， Luminal B subtype， HER-2 subtype and Basal-like subtype took up 54.8％， 18.1％， 7.7％， 19.4％. Only 971 cases had complete follow-up data. Local recurrence rate（12.3％） and distant metastasis rate（27.4％）of HER-2 subtype was significantly higher than other subtypes（P＜0.05）. The 6-year disease-free survival（DFS） rates of Luminal A subtype， Luminal B subtype， HER-2 subtype and Basal like subtype were 86.8％， 75.8％， 58.9％， 79.1％， and 6-year overall survival rates（OS） were 92.1％， 83.1％， 67.1％， 88.0％. Multivariate analysis revealed that lymph node status， histological grade， endocrine therapy and molecular subtypes were the independent prognostic factors of OS and DFS. Race was the independent prognostic factor of DFS（P＜0.05）. Conclusion Luminal A is the common subtype of breast cancer in Xinjiang， and its prognosis is the best.The prognosis of HER-2 subtype breast cancer is the worst.Lymph node status， histological grade， endocrine therapy and molecular subtypes may provide important information to predict the prognosis of breast cancer. Race is the independent prognostic factor of DFS.