ER和PR及HER-2表达与乳腺癌分子分型及临床特征和预后的关系

目的:利用雌激素受体(ER)、孕激素受体(PR)及人表皮生长因子受体2(HER-2)的免疫组织化学检测结果将乳腺癌简易分为4种分子亚型,并探讨这4种分子亚型的临床特征和影响预后的相关因素。方法:根据ER、PR及HER-2的免疫组织化学检测结果,采用回顾性方法将本院收治的175例乳腺癌患者简易分为类luminal A型、类luminal B型、类HER-2(+)型及类basal-like型4种类型。对各型的临床特征采用SPSS17.0统计软件进行分析,并用Kaplan-Meier法和Cox回归分析各型乳腺癌患者的生存情况及预后因素。结果:在175例乳腺癌患者中,类luminal A型、类luminal B型、类HER-2(+)型及类basal-like型分别占56.00%(98/175)、17.71%(31/175)、12.57%(22/175)和13.71%(24/175)。类basal-like型与类luminal A型相比,患者无瘤生存率较低(P0.05)。经Cox多因素预后分析,淋巴结阳性患者的预后较淋巴结阴性患者差;类luminal A型患者预后最好,而类basal-like型患者预后最差。结论:淋巴结状况及分子分型是影响乳腺癌预后的重要因素。依据ER、PR及HER-2行乳腺癌分子分型与国际公认分型的临床表现及预后基本一致,对指导基层医院的乳腺癌预后及治疗同样具有重要意义。

Clinical characteristics and prognosis of molecular classification in breast cancer based on ER and PR and HER-2

Objective： To explore the clinical characteristics and the prognostic factors of four subtypes in breast cancer classified by immunohistochemical results of estrogen receptor（ER）, pro- gesterone receptor （PR） and HER-2. Methods 175 breast cancer patients were divided into four different subtypes： luminal A, luminal B, HER-2 （＋） and basal-like, based on immunohistochemical results of ER, PR and HER-2. Their clinical characteristics were retrospectively reviewed by SPSS17. O. The survival rate and prognosis were also analyzed by Kaplan-Meier and Cox regression methods. Resuitt Of all the breast cancer patients, 56.00% （98/175） of patients were of luminal A subtype, 17.71% （31/175） luminal B, 12.57%（22/175） HER-2 （＋）, and 13.71% （24/175） basal-like subtype. The disease-free survival rate in basal-like subtype was lower than its in uminal A subtype （P〈0. 05）. According to the result of the Cox multiple-factor analysis, the lymph node status and molecular subtype were important factors for the prognosis of breast cancer patients. The prognosis of the pa- tients with lymph mode metastasis was worse than those without lymph node metastasis. The prognosis of luminal A subtype was best, while the basal-like subtype was the worst. Conclusion： The lymph node status and molecular subtype are the important prognostic factors. The clinical char- acteristics and prognosis of molecular classification in breast cancer based on ER, PR and HER-2 are similar to the international one. It also has great significance to the primary hospitals in treating breast cancer.