363例Luminal型乳腺癌的临床病理特点及预后分析

目的:探讨Luminal型不同分子亚型乳腺癌患者临床病理特点以及预后影响因素。方法:收集2006年1月至2013年2月诊治的363例Luminal型乳腺癌患者的临床和随访资料，分为Luminal A、Luminal B以及Luminal-HER2三组并分析临床病理参数与预后相关的因素。结果:363例Luminal型乳腺癌三种分子分型所占比例为51.5%、38.8%、9.7%，三组的发病年龄、肿瘤大小、组织学分级、淋巴结转移差异具有统计学意义（P<0.05）。局部复发率分别为2.7%、7.1%、20.0%；远处转移率为6.4%、12.1%、20.0%，Luminal-HER2型乳腺癌显著高于其余两组，且5年的无病生存以及总生存率明显低于其余两组，差异有统计学意义（P<0.05）。单因素分析和Cox多因素分析结果发现肿瘤大小、淋巴结转移、PR、HER2及内分泌治疗是Luminal型乳腺癌预后的独立影响因素(P<0.05)。结论:Luminal型乳腺癌中HER2过表达亚型患者侵袭性更强，预后更差。肿瘤较大、淋巴结转移、PR阴性、HER2过表达及未进行内分泌治疗是影响Luminal型乳腺癌预后的独立危险因素。

Clinical characteristics and prognosis of 363 patients with Luminal breast cancer

Objective:To investigate the related factors of prognosis in the various subtypes of Luminal breast cancer.Methods:The clinical and pathological data of 363 patients with Luminal breast cancer was collected and di-vided into 3 groups(Luminal A,Luminal B and Luminal -HER2),to analyze the related factors for prognosis.Re-sults:The proportion of 3 subtypes in Luminal breast cancer were 51.5%,38.8%,9.7%,with statistical difference in the onset of age,tumor size,lymph node rate,histological grade(P <0.05).Luminal -HER2 breast cancer was higher in local recurrence rate and distant metastasis rate than others and lower 5 -year overall survival(OS)and dis-ease free survival(DFS).Kaplan -Meier survival plot and multivariable Cox hazard regression analysis showed tumor size,lymph node metastasis,PR,HER2,endocrine therapy were the independent influencing factors for the prognosis of Luminal breast cancer.Conclusion:Luminal -HER2 breast cancer is more invasive and dangerous than the other two.Large tumor size,lymph node metastasis,over expression of HER2,loss of PR and absence of endocrine therapy are the independent risk factors.