Luminal B 型早期乳腺癌临床病理特点及预后危险因素分析

目的:探讨Luminal B型早期乳腺癌临床病理特点及影响预后的因素。方法:回顾性分析2010年01月至2016年06月我院收治的Luminal B型乳腺癌患者285例，分析其临床病理特点和影响预后的相关因素。结果:Luminal B(HER-2阴性)乳腺癌患者190例（66.7%），Luminal B(HER-2阳性)患者为95例（33.3%）。Luminal B(HER-2阴性)与Luminal B(HER-2阳性)在脉管癌栓、腋窝淋巴结状态和放疗例数差异具有统计学意义（P＜0.05）。Luminal B(HER-2阳性)复发转移率高（P＜0.05），且5年的无病生存和总生存率均低于Luminal B(HER-2阴性) （P＜0.05）。单因素和多因素分析显示脉管癌栓、淋巴结状态、PR和Ki-67是Luminal B型乳腺癌预后独立的影响因素（P＜0.05）。结论:与Luminal B(HER-2阴性)相比，Luminal B(HER-2阳性)乳腺癌患者恶性程度更高，预后更差。脉管癌栓、淋巴结转移、Ki-67高表达和PR阴性是影响Luminal B型乳腺癌预后的独立危险因素。

Clinicopathological characteristics and prognostic risk analysis of early Luminal B breast cancer

Objective:To investigate the clinicopathological characteristics and prognosis of early Luminal B breast cancer.Methods:From January 2010 to June 2016,285 cases of Luminal B breast cancer patients admitted to our hospital,who were enrolled to analyze the clinicopathological features and risk factors for prognosis.Results:There were 190(66.7%) cases of Luminal B(HER-2 negative) and 95(33.3%) cases of Luminal B(HER-2 positive).The cancer embolus,axillary lymph node metastasis and radiotherapy were significantly different between Luminal B(HER-2 negative) and Luminal B(HER-2 positive)（P＜0.05）.Luminal B(HER-2 positive) breast cancer had higher local recurrence rate and distant metastasis rate（P＜0.05）,and the 5-year disease free survival(DFS) and overall survival(OS) were lower（P＜0.05）.Univariate and multivariate analysis revealed that lymph node status,cancer embolus，PR and Ki-67 were independent influencing factors for prognosis in Luminal B breast cancer.Conclusion:Compared with Luminal B(HER-2 negative),Luminal B(HER-2 positive) breast cancer patients has higher malignancy and relatively poor prognosis.Cancer embolus,lymph node metastasis,high expression of Ki-67 and PR negative are independent risk factors for poor prognosis in Luminal B breast cancer.