不同亚型乳腺癌的治疗效果及预后分析

目的：探讨不同亚型乳腺癌的治疗效果及其预后。方法：回顾性分析2003年6月～2012年12月在我院初诊并接受治疗的223例乳腺癌患者的临床资料，采用免疫组织化学方法确定其分子分型，分析不同亚型乳腺癌的临床病理特征，并分析采用同一种治疗方法治疗不同亚型乳腺癌的治疗效果和预后。结果：在本组病例中，乳腺癌的分型在不同肿瘤直径、组织学分级以及淋巴结转移间的分布差异均有统计学意义（P〈0．05）；经卡方检验，复发率最低的是LuminalA型，其次是LuminalB型，人表皮生长因子受体-2（HER-2）阳性型及基底细胞样型复发率最高（P〈0．05）；4种亚型的病死率差异也具有统计学意义（P〈0．05），最低的是LuminalA型，HER=2过表达型的病死率最高；LuminalA型乳腺癌的预后最好，其次为LuminalB型、基底样细胞型，HER-2过表达型乳腺癌的预后最差（P=0．016）。结论：乳腺癌的分子分型对评估乳腺癌的病情严重程度、指导治疗、预测预后提供了重要的依据，为分子靶向治疗提供了新的方向。

Treatment and prognosis of different subtype breast cancer

Objective= To investigate the therapeutic effects and prognosis of different subtypes ot breast cancer. Methods. Clinical data of 223 cases of newly diagnosed breast cancer was analyzed retrospec- tively. Molecular typing was determined by immunohistochemical assay. Clinical pathological features, therapeutical effect and prognosis of different subtypes were analyzed. Results： There were significant differences in tumor size, histological grade and lymph node metastasis among patients with different sub- types of breast cancer （P〈0.05）. Chi-square test showed the recurrence rate of Luminal A type was the lowest, followed by the Luminal B type. Patients with HER-2-positive type and basal cell-like type had highest recurrence rate （P〈0.05）. The difference in mortality was also significantly different （P〈0.05）, the lowest was Luminal A type and HER-2 was the highest. The prognosis of Luminal A type was best, ollowed by Luminal B type, basal-like cell type, HER-2 （P= 0. 016）. Conclusions= The molecular sub- types of breast cancer can be used to assess the severity targeted therapy. and provide an important basis for the molecular