广西地区家族性乳腺癌临床病理特征及预后的相关研究

目的 比较家族性乳腺癌和散发性乳腺癌患者的临床病理特征，揭示家族性乳腺癌独特的临床病理学及分子生物学特性。方法 回顾性分析广西医科大学第一附属医院胃肠腺体外科2013年1月~2014年1月期间收治中的445例女性乳腺癌患者临床病理资料，其中家族性乳腺癌患者43例，散发性乳腺癌402例。比较分析两组临床病理特征、分子生物学行为以及复发、转移等情况。结果 在组织学分级中家族性乳腺癌患者分为Ⅲ级所占的比例（37.2%）高于散发性乳腺癌患者所占的比例（22.6%），差异有统计学意义（χ2=4.517，P=0.034）；家族性乳腺癌患者的雌激素受体（estrogen receptor，ER）表达阴性率（39.5%）高于散发性乳腺癌患者（25.4%），差异有统计学意义（χ2=3.977，P=0.046）；Kaplan-Meier生存分析显示:家族性乳腺癌组3年无病生存率（disease free survival，DFS）为86.0%，而散发性组3年无病生存率为95.5%，差异有统计学意义（χ2=7.371，P=0.007）。但两组患者在年龄分布、民族、体质指数（body mass index，BMI）、绝经状态、肿瘤大小、病理类型、临床分期、腋窝淋巴结转移率、孕激素受体（progestrone receptor，PR）、人类表皮生长因子受体-2（human epidermal growth factor receptor-2，HER-2）、细胞核增殖抗原（cell nucleus generation antigen，Ki-67）表达以及乳腺癌分子分型方面差异均无统计学意义（均有P>0.05）。结论 广西地区家族性乳腺癌与散发性乳腺癌在一些临床病理特征上存在差异，可能提示预后不良。

Study on clinicopathological characteristics and prognosis of familial breast cancer in Guangxi

Objective To compare the clinicopathological characteristics between familial breast cancer and sporadic breast cancer,and to reveal the unique clinical pathology and molecular biological characteristics of familial breast cancer.Methods The clinical and pathological data of 445 patients with breast cancer from January 2013 to January 2014 in Department of Gastrointestinal and Gland Surgery,the First Affiliated Hospital of Guangxi Medical University were analyzed retrospectively,43 of them were familial breast cancer and 402 were sporadic.The clinical pathological features,molecular biological behaviors,recurrence and metastasis of the two groups were compared and analyzed.Results The proportion of patients with familial breast cancer at histological grade Ⅲ(37.2％) was significantly higher than the sporadic breast cancer (22.6％),the difference was statistically significant (x2 =4.517,P =0.034).The negative rate of ER expression in familial breast cancer patients (39.5％) was higher than that in sporadic breast cancer patients (25.4％),the difference was statistically significant (x2 =3.977,P =0.046).Kaplan-Meier survival analysis showed that:3-year diseasefree survival rate (DFS) was 86.0％ in the familial breast cancer and the rate in the sporadic group was 95.5％,the difference was statistically significant (x2 =7.371,P =0.007).But in the two groups,the age distribution,nationality,BMI,menopausal status,tumor size,pathological type,clinical stage,axillary lymph node metastasis rate,PR,HER-2,Ki67 and breast cancer molecular subtypes were not statistically significant.Conclusions There are some differences in clinicopathological characteristics between the familial breast cancer and sporadic breast cancer in Guangxi province,and familial breast cancer may indicate worse prognosis.