218例不同分子亚型浸润性乳腺癌患者的临床特征

The clinical features of different molecular subtypes of 218 invasive breast cancer cases

目的:探讨浸润性乳腺癌分子亚型在中国人群中的分布,以用于判断临床预后和指导治疗。方法:回顾分析218例浸润性乳腺癌患者,根据雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER2)的水平划分为4个分子亚型。对比分析4型患者的分布比例、发病年龄、病理组织学分类、肿瘤最大径以及淋巴结转移等相关因素。结果:在4型中,luminal A型例数最多,共131例(60.1%);basal-like型共有63例(28.9%);luminal B型和HER2过表达型所占比例较少,均为12例(5.5%)。发病年龄以40岁～59岁年龄段发生乳腺癌例数最多,达到77.06%。HER2过表达型在50岁～59岁年龄段发病例数显著增高,与其余3组相比有显著性差异(P<0.05)。病理分类显示,浸润性导管癌最多,各型之间无显著性差异(P>0.05);从淋巴结阳性病例中,HER2过表达型和luminal B型多枚淋巴结转移比例更高(P<0.05)。肿瘤最大径分析显示,HER2过表达型和basal-like型病例肿瘤最大径2cm～5cm的比例较高,而luminal A型和luminal B型的肿瘤最大径多小于2cm(P<0.05)。结论:在4型中,luminal A型所占比例最高;HER2过表达型在50岁～59岁年龄段发病较多见;浸润性导管癌是最常见的病理组织类型;HER2过表达型和luminal B型多枚淋巴结转移情况更多发生;HER2过表达型和basal-like型肿瘤较luminal A型更大。

Objective ：To investigate the distribution of different molecular subtypes of invasive breast cancer among Chinese people for clinical prognosis and directing treatment. Methods： Total of 218 invasive breast cancers were classified into four different subtypes according to estrogen receptor（ ER）, progestogen receptor（PR） and epidermal growth factor receptor2 （ HER2 ）. The factors such as age, histopathological type, lymph nodal status, tumor size and distribution of molecular subtype were observed. Results： Luminal A cases were the majority, 131 cases （60.1%）, basal -like was the second largest group, 63 cases （28.9%）, luminal B and HER2 - overexpressing were two smallest groups, 12 cases（5.5% ） and 12 cases（5.5% ） respectively. Most subjects were of 40 -59 years old （77.06%）. The HER2 - overexpressing breast cancer subtype patients,age was 50 to 59 （ P 〈 0.05 ）, with significant difference to the rest subtype groups. Pathological analysis showed that invasive ductal carcinoma was more than invasive lobular carcinoma and other histological types（ P 〉0.05 ）. There were more lymph nodes metastasis in HER2 - overexpressing and luminal B groups （ P 〈 0.05 ）. HER2 - overexpressing and basal - like subtype groups had more large- tumor- size cases （2cm to 5cm）. While most cases in luminal A and luminal B subtyes were less than 2cm（ P 〈0.05 ）. Conclusion： Most cases of invasive breast cancers are luminal A subtype. Cases of HER2 - overexpressing are more in the age of 50 to 59 years old. Invasive ductal carcinoma are more often in the four subtypes. More lymph nodes metastasis happened in HER2 -overexpressing and luminal B subtypes. The tumor size of HER2 - overexpressing and basal - like subtypes are bigger than that of luminal A subtypes.