HER-2等病理特征对乳腺癌患者术后转移部位的影响

Effect of HER-2 overexpression and other tumor characteristics on metastasis sites of breast cancer patients after operation

目的分析乳腺癌术后患者不同转移部位间的差异,从而进一步探索乳腺癌的转移规律。方法回顾性研究了210位乳腺癌术后发生复发转移的患者,并采用多因素分析对不同转移部位患者的临床及肿瘤特征进行比较。结果单因素分析显示非内脏转移(淋巴结、骨转移)患者的平均年龄显著高于内脏转移(肺、肝、脑)者(50.71比46.69,P=0.012);HER-2的阳性率则显著低于内脏转移者(10.6%比25.4%,P=0.05)。Cox回归分析结果显示年龄较大(RR=0.927,95%CI0.877～0.981,P=0.008)、HER-2阴性者(RR=0.253,95%CI0.076～0.836,P=0.024)易倾向非内脏转移;原发灶较大者(RR=3.832,95%CI1.073～13.687,P=0.039)则易向内脏转移。结论不同临床和生物学特征的乳腺癌患者可能会发生不同部位的转移,且转移的机制可能不同。

Objective To analyze the breast caner patients with different sites of recurrence,and to have knowledge of the regular pattern of metastatic breast cancer.Methods We retrospectively analyzed 210 women with metastatic breast cancer.The clinical and biological characteristics were compared between the patients with organ metastases（lung,liver,brain）and non-viscera metastases（lymph node,bone）.The Cox regression analysis was used to test the risk factors.Results Univariate analysis indicated that the average of age was significantly lower（50.71 vs 46.69,P=0.012）in the patients with viscera metastases,and the rate of HER-2 overexpression was also significantly higher（10.6% vs 25.4%,P=0.05）.Cox regression analysis showed that patients with elder age（RR=0.927 95%CI 0.877-0.981,P=0.008）,HER-2 negative overexpression（RR=0.253 95%CI 0.076-0.836,P=0.024）tended to develop non-viscera metastases,while patients with larger tumors（RR=3.832 95%CI 1.073-13.687,P=0.039）tended to develop organ metastases.Conclusions Patients with different clinical and biological characteristics may develop recurrence in different sites.There may be different mechanisms of metastasis for recurrence in different sites.