雌孕激素受体与女性原发乳腺癌术后复发转移关系的临床研究

Clinical research on ER, PR status with recurrence and distant metastatic site in primary breast cancer

目的：分析乳腺癌患者雌激素受体（estrogen receptor，ER）和孕激素受体（progesterone receptor，PR）状态与术后复发、转移部位的关系。方法：1989-1994年经天津医科大学附属肿瘤医院收治乳腺癌病例且雌、孕激素受体明确、术后随访完整的病例1372例。根据ER和PR状态分组，总结职和PR状态与首次治疗后发生复发、转移部位的关系。结果：ER＋／PR＋组患者皮肤、骨骼转移率为10．91％，明显高于ER-／PR-组（5．56％），P=0．0053；ER-／PR-组内脏转移率为15．56％，高于ER＋／PR＋组（3．64％），P=0．0000。激素依赖性组5年总生存率和无瘤生存率（82．31％，80．04％）高于非激素依赖性组（77．22％，73．89％），P〈0．05。两组10年总生存率、无瘤生存率并无区别。结论：乳腺癌在晚期转移部位与ER、PR受体状态有关，ER＋／PR＋组5年总生存率、无瘤生存率高于ER-／PR-组，进行综合治疗是提高总生存率、无瘤生存率的关键。

To analyze the ER, PR status of breast cancer with the recurrence and distant metastatic site following radical mastectomy. METHODS： A total of 1 372 patients treated in Tianjin Cancer Hospital, and with entire ER, PR status and follow-up records were studied. These cases were devided into two groups according to the ER,PR status. The hormone status＇ relationship between the recurrence and distant metastatic site was discussed. RESULTS： The rate of bone metastasis in breast cancer pafiems with ER＋/PR＋ was higher than that of patients with ER--/PR--（P=0. 005 3）, the vercercal metastasis was more seen in the ER--/PR-- patients than that in the ER＋/PR＋ patients, P=0. 000 0. The 5-year total survival and DFS rates in hormone dependent group （82. 31%, 80. 04%） were higher than those in the non hormone group （77. 22%, 73. 89% ）, P〈0. 05. The 10-year total survival and DFS rate had no significant difference between the two groups. O3NCLUSIONS： The breast cancer can be of metastases in blood of advanced stage. The metastatic site is correlated with the ER, PR status, and the 5-year total survival and DFS rate are higher in the ER＋/PR＋ group than those in the ER--/PR-- group. The combined treatment can raise the survival rate.