CAJ | 학술논문

[目的] 探讨浸润性乳腺癌近似分子亚型的临床意义. [方法] 回顾性分析浸润性乳腺癌患者,依据免疫组化雌激素受体(ER)、孕激素受体(PR)、HER2水平将其近似划分为Luminal A (ER+ 和/或 PR+,HER2-)、Luminal B (ER+ 和/或 PR+,HER2+)、HER2+(EP-,PR-,HER2+)和Basal-like(EP-,PR-,HER2-) 4个分子亚型,各362、107、86和148例,对比分析该4型患者的分布比例、发病年龄、绝经状态、病理组织学类型、病理分级、肿瘤大小、淋巴结状态等临床特征及首次复发时间和部位的特点.[结果] 所有703例患者中,Luminal A型比例最高,占51.5%;Luminal B和HER2+型所占比例最少.整体人群发病年轻,90.8%的患者在59岁以下.其中40岁以下患者Luminal A型最多.不同分子亚型病理分级构成差异显著,Luminal A型中,组织学1级患者比例最高,并且T1期肿瘤比例明显高于其他各亚型,HER2+型则以T4期肿瘤最多.各亚型间淋巴结分布无明显差异,仅在Luminal B和HER2+型出现N3高比例分布趋势.复发转移患者中,Luminal A型首次复发时间最长,HER2+型最短,且HER2+和Basal-like型肺转移率高.与国外报道不同,本研究未显示出各亚型中局部复发与远处转移的分布差异. [结论] 蛋白标记近似分子分型简单明了,切实可行.国人乳腺癌具有蛋白标记近似的不同分子亚型,与国外大体相似,Luminal A型临床特征相对较好,HER2+型与Basal-like型具有较高的肺转移率.但仍有不同之处,尤其是Luminal A型年龄分布呈现年轻化.
[목적] 탐토침윤성유선암근사분자아형적림상의의. [방법] 회고성분석침윤성유선암환자,의거면역조화자격소수체(ER)、잉격소수체(PR)、HER2수평장기근사화분위Luminal A (ER+ 화/혹 PR+,HER2-)、Luminal B (ER+ 화/혹 PR+,HER2+)、HER2+(EP-,PR-,HER2+)화Basal-like(EP-,PR-,HER2-) 4개분자아형,각362、107、86화148례,대비분석해4형환자적분포비례、발병년령、절경상태、병리조직학류형、병리분급、종류대소、림파결상태등림상특정급수차복발시간화부위적특점.[결과] 소유703례환자중,Luminal A형비례최고,점51.5%;Luminal B화HER2+형소점비례최소.정체인군발병년경,90.8%적환자재59세이하.기중40세이하환자Luminal A형최다.불동분자아형병리분급구성차이현저,Luminal A형중,조직학1급환자비례최고,병차T1기종류비례명현고우기타각아형,HER2+형칙이T4기종류최다.각아형간림파결분포무명현차이,부재Luminal B화HER2+형출현N3고비례분포추세.복발전이환자중,Luminal A형수차복발시간최장,HER2+형최단,차HER2+화Basal-like형폐전이솔고.여국외보도불동,본연구미현시출각아형중국부복발여원처전이적분포차이. [결론] 단백표기근사분자분형간단명료,절실가행.국인유선암구유단백표기근사적불동분자아형,여국외대체상사,Luminal A형림상특정상대교호,HER2+형여Basal-like형구유교고적폐전이솔.단잉유불동지처,우기시Luminal A형년령분포정현년경화.
[Objective] To investigate the clinical significance of approximated molecular subtype.[Methods] Four different subtypes were defined by immunohistochemical (IHC) markers as estrogen receptor (ER),progesterone receptor (PR) and HER2.Clinical characteristics as distribution,age,menopausal status,histopathologic type and grading,tumor size,lymph node status,time to and place of first tumor recurrence were analyzed.[Results] Among all 703 cases,Luminal A was the majority (51.5%) and the least were Luminal B and HER2+.90.8% the patients were less than 59 years old with Luminal A.Different subtype has different histopathologic grading.Luminal A was more than others among grading 1 tumors and it has more T1 tumors,while T4 tumors was most among HER2+ ones.Lymph nodes metastasis has no significant difference between different groups,other than high proportion tendency of N3 stage in Luminal B and HER2+.In addition,Luminal A has the longest time to the first recurrence while HER2+ was the shortest.Moreover,HER2+ and Basal-like have high rates of lung metastasis.Different from foreign reports,the distribution of the first recurrent place and distant metastases have no significant difference.[Conclusion] The classification of breast cancer approximated molecular subtype defined by IHC markers was feasible.The distribution is similar to other countries.Luminal A has rather better clinical characteristics while HER2+ and Basal-like have high rates of lung metastasis.However,Luminal A has the highest proportion of young patients,which is different from other countries.