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维吾尔族女性乳腺癌分子分型的临床特征及预后特点
引用本文:王明龙,王晓文,张明帅,欧江华. 维吾尔族女性乳腺癌分子分型的临床特征及预后特点[J]. 中国普通外科杂志, 2014, 23(11): 1533-1538
作者姓名:王明龙  王晓文  张明帅  欧江华
作者单位:(新疆医科大学附属肿瘤医院 乳腺外科,新疆 乌鲁木齐 830011)
基金项目:国家自然科学基金资助项目(81260390)。
摘    要:目的:分析维吾尔族可手术女性乳腺癌患者不同分子分型的临床特征及其预后特点。方法:收集2007年1月—2009年4月新疆医科大学附属肿瘤医院首诊且完成手术治疗,有完整病历资料的的维吾尔族女性乳腺癌患者资料528例,分析各亚型乳腺癌的临床特征、复发转移及生存情况。结果:528例患者中,luminal A型95例(18.0%)、luminal B型224例(42.4%)、HER-2过表达型56例(10.6%)、三阴乳腺癌(TNBC)153例(29.0%);TNBC患者中,临床分期III期、发病年龄≤35岁、腋窝淋巴结转移数≥4个的构成比高于其他亚型,激素受体阴性患者肿瘤直径>2 cm的构成比大于激素受体阳性患者;发病年龄36~65岁组中,HER-2过表达型构成比高于其他亚型;luminal B型患者中,有恶性肿瘤家族病史的构成比明显高于其他亚型;复发转移患者中,内脏转移以HER-2过表达型(16/27,59.3%)及TNBC(55/94,58.5%)多见、骨转移以luminal A型(11/19,60.0%)多见、TNBC局部复发率(6/94,6.4%)较其他亚型低;luminal A型、luminal B型、HER-2过表达型、TNBC型患者5年总生存率分别为91.6%、85.6%、75.0%、65.3%,5年无病生存率分别为83.1%、75.9%、55.4%、44.4%;以上差异均有统计学意义(均P<0.05)。结论:维吾尔族女性乳腺癌患者中,luminal B型是最常见的分子亚型,Luminal A型预后最好,HER-2过表达型及TNBC预后最差。

关 键 词:乳腺肿瘤;分子分型;预后;少数民族
收稿时间:2014-06-11
修稿时间:2014-10-13

Clinical characteristics and outcomes of different molecular subtypes of breast cancer in Uygur females
WANG Minglong,WANG Xiaowen,ZHANG Mingshuai,OU Jianghua. Clinical characteristics and outcomes of different molecular subtypes of breast cancer in Uygur females[J]. Chinese Journal of General Surgery, 2014, 23(11): 1533-1538
Authors:WANG Minglong  WANG Xiaowen  ZHANG Mingshuai  OU Jianghua
Affiliation:(Department of Breast Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, China)
Abstract:Objective: To analyze the clinical characteristics and outcomes of resectable breast cancer of different molecular subtypes in Uygur females. Methods: The data of 528 Uygur female patients with complete medical record, and initial diagnosis and surgical treatment in Affiliated Tumor Hospital of Xinjiang Medical University between January 2007 and April 2009 were collected. The clinical features, recurrence, metastasis and survival of different breast cancer subtypes were analyzed.Results: Among the 528 patients, 95 cases were luminal A subtype, 224 cases were luminal B subtype, 56 cases were HER-2-enriched subtype, and 153 cases were triple negative breast cancer (TNBC). In TNBC patients, the constituent ratios of cases with clinical stage III, age at onset equal to or less than 35 years, and number of axillary lymph nodes equal to or more than 4 were significantly higher than those in patients of other subtypes; the constituent ratio of cases with tumor size larger than 2 cm in patients with hormone-receptor-negative breast cancer was significantly higher than in those with hormone-receptor-positive breast cancer; the constituent ratio of HER-2-enriched subtype was significantly higher than other subtypes in group of patients aged from 36 to 65 years; the constituent ratio of cases having family history of malignant neoplasm in luminal B subtype patients was significantly higher than that in patients of other subtypes (all P<0.05). In patients with recurrence and metastasis, the visceral metastasis was frequently seen in HER-2-enriched subtype (16/27, 59.3%) and TNBC (55/94, 58.5%) cases, bone metastasis was mainly seen in cases of luminal A subtype (11/19, 60.0%), and the local recurrence rate in TNBC cases (6/94, 6.4%) was lower than that in cases of other subtypes. For patients of luminal A, luminal B, HER-2-enriched subtype and TNBC, the 5-year overall survival rate was 91.6%, 85.6%, 75.0% and 65.3%, and the 5-year disease-free survival rate was 83.1%, 75.9%, 55.4% and 44.4%, respectively. All the differences had statistical significance (all P<0.05).Conclusion: Among Uygur female breast cancer patients, luminal B is the most common molecular subtype, and those with luminal A subtype have a relatively good prognosis, while those with HER-2-enriched subtype and TNBC have an unfavorable outcome.
Keywords:Breast Neoplasms   Molecular Typing   Prognosis   Minority Groups
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