CAJ | 학술논문

目的观察乳腺癌分子分型对乳腺癌患者保乳手术预后的影响.方法回顾性分析天津医科大学肿瘤医院1999年1月至2007年12月期间收治的699例行保乳手术的乳腺癌患者的临床资料.按术后免疫组化结果将患者分为4组:Luminal A[雌激素受体(ER)+/孕激素受体(PR)+/表皮生长因子受体(HER)2-,Ki-67＜14％)],Luminal B(ER +/PR+/HER2±,Ki-67＞14％),HER2(ER-/PR-/HER2+)和三阴性(ER-/PR-/HER2-).根据不同分组,比较其生存率、复发及转移等预后影响因素.结果 699例保乳患者中,其中局部复发患者42例,5年复发率6.0％,远处转移42例,占6.0％,乳腺癌5年生存率91.8％.多因素结果显示不同分子分型(P＜0.001),淋巴结状态(P ＜0.001)及是否进行化疗(P＜0.001)的患者的乳腺癌生存率和远处转移率差异有统计学意义.虽然单因素分析显示不同分子分型乳腺癌患者保乳术乳后局部复发存在差异(P =0.022),但多因素结果显示分子分型并不是局部复发的独立预后因素(P =0.081).结论虽然与其他类型乳腺癌患者相比,三阴性患者的预后较差,但是保乳治疗仍然是该类患者可行的治疗选择.
목적 관찰유선암분자분형대유선암환자보유수술예후적영향.방법 회고성분석천진의과대학종류의원1999년1월지2007년12월기간수치적699례행보유수술적유선암환자적림상자료.안술후면역조화결과장환자분위4조:Luminal A[자격소수체(ER)+/잉격소수체(PR)+/표피생장인자수체(HER)2-,Ki-67＜14％)],Luminal B(ER +/PR+/HER2±,Ki-67＞14％),HER2(ER-/PR-/HER2+)화삼음성(ER-/PR-/HER2-).근거불동분조,비교기생존솔、복발급전이등예후영향인소.결과 699례보유환자중,기중국부복발환자42례,5년복발솔6.0％,원처전이42례,점6.0％,유선암5년생존솔91.8％.다인소결과현시불동분자분형(P＜0.001),림파결상태(P ＜0.001)급시부진행화료(P＜0.001)적환자적유선암생존솔화원처전이솔차이유통계학의의.수연단인소분석현시불동분자분형유선암환자보유술유후국부복발존재차이(P =0.022),단다인소결과현시분자분형병불시국부복발적독립예후인소(P =0.081).결론 수연여기타류형유선암환자상비,삼음성환자적예후교차,단시보유치료잉연시해류환자가행적치료선택.
Objective To evaluate the effects of molecular subtypes on the prognosis of breast cancer patients after BCT (breast-conserving therapy).Methods From January 1999 to December 2007,a total of 699 female patients on BCT were analyzed retrospectively.They were grouped according to the results of immunohistochemistry,they were grouped as Luminal A (ER +/PR +/HER2-,Ki-67 ＜ 14％),Luminal B (ER +/PR +/HER2 ±,Ki-67 ＞ 14％),HER2 (ER-/PR-/HER2 +) and triple negative breast cancer (TNBC) (ER-/PR-/HER2-).Results Among them,the recurrence rate,metastasis rate and survival rate within 5 years after BCT accounted for 6.0％,6.0％ and 91.8％ respectively.There were statistical differences in metastasis rate and survival rate among patients with different molecular subtypes (P ＜0.001),lymph node status(P ＜ 0.001) and on chemotherapy or not (P ＜ 0.001) on multivariate analysis.Though,on univariate analysis,different molecular subtypes had different risks for local failure (P =0.022).On multivariate analysis,this difference was not statistically significant (P =0.081).Conclusion Despite a worse prognosis of TNBC versus other subtypes,BCT is a viable option for selected TNBC patients.