CAJ | 학술논문

目的探讨乳腺癌分子分型与出现复发转移部位、时间的相关性.方法选取2004年7月至2012年6月在本院治疗的62例原发性女性乳腺癌术后复发转移患者,收集上述复发转移病例的雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER2)的免疫组化检测结果,了解肿瘤复发转移发生的部位和时间,将发生复发转移的患者根据首次复发转移部位分为局部复发组和远处转移组,分析乳腺癌各分子亚型患者首发复发转移部位和时间的相关性.针对乳腺癌患者复发与转移出现的先后顺序及比例进行分析.结果局部复发23例；远处转移39例,其中死亡11例.HER2过表达型和basal-like型患者内脏转移率高(P =0.01、P=0.001)；出现复发转移时间分布显示:luminal A型35％的患者复发转移发生在术后3年内,basal-like型患者75％的复发转移发生在术后3年内；luminal B型及HER2过表达型者,复发转移几乎均发生在术后3年内,5年后复发转移率明显降低.结论乳腺癌分子分型在评估患者术后复发转移的部位和时间方面是TNM分期法的重要补充,有助于患者术后随访的个体化筛查.
목적 탐토유선암분자분형여출현복발전이부위、시간적상관성.방법 선취2004년7월지2012년6월재본원치료적62례원발성녀성유선암술후복발전이환자,수집상술복발전이병례적자격소수체(ER)、잉격소수체(PR)、인류표피생장인자수체2(HER2)적면역조화검측결과,료해종류복발전이발생적부위화시간,장발생복발전이적환자근거수차복발전이부위분위국부복발조화원처전이조,분석유선암각분자아형환자수발복발전이부위화시간적상관성.침대유선암환자복발여전이출현적선후순서급비례진행분석.결과 국부복발23례；원처전이39례,기중사망11례.HER2과표체형화basal-like형환자내장전이솔고(P =0.01、P=0.001)；출현복발전이시간분포현시:luminal A형35％적환자복발전이발생재술후3년내,basal-like형환자75％적복발전이발생재술후3년내；luminal B형급HER2과표체형자,복발전이궤호균발생재술후3년내,5년후복발전이솔명현강저.결론 유선암분자분형재평고환자술후복발전이적부위화시간방면시TNM분기법적중요보충,유조우환자술후수방적개체화사사.
Objective To investigate the risk distribution of breast cancer for location and time of recurrence metastasis in molecular subtype.Methods We studied retrospectively the female patients who were diagnosed as invasive ductal breast cancer in our hospital from July 2004 to June 2012,detected ER,PR,and HER2 expressions in the paraffin sections.The patients with recurrence metastasis were divided into local recurrence and distant metastasis with the first transfer site as standard for analyzing the distribution in molecular subtype and the time of the first site of recurrence metastasis.Results Sixty two patients were encountered recurrence metastasis,including 23 patients with local recurrence,and 39 patients with distant metastasis,death 11.The rates of distant metastasis for patients who belonged to HER2 type and basal-like type were higher than that of local recurrence (P =0.01,P =0.001).The risk distribution of recurrence metastasis time in molecular recurrence metastasis showed that 35 percent of recurrence metastasis time of luminal A type was first 3 years,75 percent of molecular subtype of basa1-1ike type recurrence metastasis time in first 3 years and advanced.The peak of luminal B and HER2 type was first 3 years,and very low in 5 years.Conclusions Molecular subtype of breast cancer is an important complement for TNM method in accurately assessing the patients of recurrence metastasis for location and time,and is helpful for the individual screening of patients for recurrence metastasis.