不同分子分型乳腺癌的临床病理特征及预后的关系

目的 探讨乳腺癌分子分型与临床病理特征及预后的关系.方法 选择126例乳腺癌患者,按孕激素受体(PR)、雌激素受体(ER)和人类表皮生长因子受体-2(HER-2)的状态分为Luminal A型、Luminal B型、HER-2过度表达型和Basal-like型,比较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 156例乳腺癌患者中,Luminal A型68例(54.0%)、Luminal B型22例(17.5%)、HER-2过度表达型9例(7.1%)、Basal-like型27例(21.4%).乳腺癌不同分子分型间绝经状态、肿瘤直径、淋巴结转移数目、临床分期及组织学分级的差异均有统计学意义(P<0.05).HER-2过度表达型与Basal-like型的局部复发率分别为33.3%和14.8%,远处转移率分别为55.6%和40.7%,均高于其他2种亚型,差异均有统计学意义(P<0.05).4组中位无瘤生存时间的差异有统计学意义(χ2=8.002,P<0.05),HER-2过度表达型与Basal-like型的MPFS较短.结论 HER-2过表达型和Basal-like型乳腺癌的病理学特征较差,且预后不良;而Luminal A型预后较好.

Clinicopathological Features and Prognosis of Different Molecular Types of Breast Cancer

Objective To investigate the relationship between molecular typing and clinicopathological features and prognosis of breast cancer. Methods 126 patients with breast cancer were divided into Luminal type A,Luminal type B,HER-2 overexpression type and Basal-like type according to progesterone receptor ( PR) ,estrogen receptor ( ER) and human epidermal growth factor receptor-2 ( HER-2 ) . Clinicopathological features, recurrence, metastasis and prognosis of patients with different molecular types of breast cancer were compared. Results In 156 cases of breast cancer,there were 68 cases (54. 0%) of Lu-minal A type,22 cases (17. 5%) of Luminal B type,9 cases (7. 1%) of HER-2 overexpression type and 27 cases (21. 4%) of Basal-like type. There were significant differences in the menopausal status,tumor diameter,lymph node metastasis,clinical stage and histological grade between different molecular types of breast cancer (P<0. 05). The local recurrence rates of HER-2 overex-pression type and Basal-like type were 33. 3% and 14. 8%,respectively. The distant metastasis rates were 55. 6% and 40. 7%, respectively,which were higher than those of the other 2 subtypes,the differences were statistically significant (P<0. 05). (P<0. 05). The HER-2 overexpression type was shorter than that of Basal-like type (P<0. 05). There was a significant difference be-tween the 2 groups (P<0. 05). Conclusion HER-2 overexpression and Basal-like breast cancer pathology is poor with poor prognosis;and Luminal A type has better prognosis.