CAJ | 학술논문

　　目的：探讨同期腋淋巴结转移病灶雌激素受体（estrogen receptor，ER）和孕激素受体（progesterone receptor，PR）补测在激素受体阴性浸润性乳腺癌中的临床意义。方法：观察2012年7月至2013年1月，重庆医科大学附属第一医院内分泌乳腺外科门诊随访及住院患者中补测激素受体阴性乳腺癌同期腋淋巴结转移病灶ER和PR的表达情况，所有标本（包括原发癌病灶及同期腋淋巴结转移病灶）的免疫组织化学检测均由重庆医科大学病理检测中心进行，根据检测报告，原发病灶阴性而腋淋巴结转移病灶ER和/或PR阳性者补加内分泌治疗。结果：56例激素受体阴性乳腺癌中，同期腋淋巴结转移病灶ER阳性8例（14.3%），PR阳性2例（3.6%），ER和PR均阳性3例（5.4%），共13例（23.3%）因补查腋淋巴结转移病灶ER和/或PR变阳性而在随访中加用内分泌治疗。肿瘤原发病灶与腋转移淋巴结ER和PR均阴性43例（76.7%），即肿瘤原发癌病灶与腋转移淋巴结ER和PR均为阴性表达的总符合率为76.7%，不一致率为23.3%。结论：受体阴性浸润性乳腺癌原发病灶与腋淋巴结转移病灶ER和PR表达具有一定的不一致性，对原发癌病灶激素受体阴性乳腺癌患者应检查其同期腋淋巴结转移病灶受体的表达，可能筛查出原发病灶受体阴性而复发转移病灶受体阳性患者，及时加用内分泌治疗，提高该类患者的疗效，亦可解释部分激素受体阴性而内分泌治疗也有一定疗效的原因。
　　목적：탐토동기액림파결전이병조자격소수체（estrogen receptor，ER）화잉격소수체（progesterone receptor，PR）보측재격소수체음성침윤성유선암중적림상의의。방법：관찰2012년7월지2013년1월，중경의과대학부속제일의원내분비유선외과문진수방급주원환자중보측격소수체음성유선암동기액림파결전이병조ER화PR적표체정황，소유표본（포괄원발암병조급동기액림파결전이병조）적면역조직화학검측균유중경의과대학병리검측중심진행，근거검측보고，원발병조음성이액림파결전이병조ER화/혹PR양성자보가내분비치료。결과：56례격소수체음성유선암중，동기액림파결전이병조ER양성8례（14.3%），PR양성2례（3.6%），ER화PR균양성3례（5.4%），공13례（23.3%）인보사액림파결전이병조ER화/혹PR변양성이재수방중가용내분비치료。종류원발병조여액전이림파결ER화PR균음성43례（76.7%），즉종류원발암병조여액전이림파결ER화PR균위음성표체적총부합솔위76.7%，불일치솔위23.3%。결론：수체음성침윤성유선암원발병조여액림파결전이병조ER화PR표체구유일정적불일치성，대원발암병조격소수체음성유선암환자응검사기동기액림파결전이병조수체적표체，가능사사출원발병조수체음성이복발전이병조수체양성환자，급시가용내분비치료，제고해류환자적료효，역가해석부분격소수체음성이내분비치료야유일정료효적원인。
Objective:This study aimed to investigate the clinical significance of hormone receptor status detection in simultane-ous axillary metastasis for hormone receptor-negative primary breast cancer patients. Methods:Using immunohistochemical methods, hormone receptor status detection in axillary lymph node metastasis was performed among breast cancer patients with simultaneous ax-illary metastasis in the First Affiliated Hospital of Chongqing Medical University. The subjects comprised patients who visited the clin-ic for follow up or those who were hospitalized from July 2012 to January 2013. Endocrine therapy was given for patients diagnosed with positive hormone receptor in their simultaneous axillary metastasis. Results:Out of 56 patients with hormone receptor-negative primary breast cancer, 14.3%gained estrogen receptor (ER), 3.6%gained progesterone receptor (PR), and 5.4%gained ER and PR in their simultaneous axillary metastasis, and then underwent endocrine therapy. The discordance rate of hormone receptor expression be-tween primary tumor and axillary metastasis was 23.3%. Conclusion:Some discordance rates of hormone receptor status between pri-mary tumor and simultaneous axillary metastasis were observed. Through hormone receptor status detection in simultaneous axillary metastasis, we may possibly distinguish patients with negative ER and PR, among whom endocrine therapy may be active.