Basal—like乳腺癌临床病理特征与预后分析

The clinicopathologic characterizations and prognosis in patients of basal-like breast cancer

目的分析Basal-like乳腺癌的临床病理特征与预后。方法收集25例Basal-like乳腺癌患者资料，回顾性分析此型乳腺癌的临床病理特征及5年无瘤生存率与总生存率，并与同期收治的34例CerbB＋型、37例ER＋型乳腺癌患者的临床病理特征和生存率进行对比分析。结果Basal-1ike乳腺癌占同期乳腺癌的15．7％，与CerbB2＋型和ER＋型乳腺癌相比，Basal-like乳腺癌患者年龄相对较大，≥50岁的患者占56．0％，而CerbB2＋型仅占29．4％，ER＋型占35．1％（P〈0．05）；Basal．1ike乳腺癌与ER＋型比，体积相对较大（P〈0．05），但Basal-like型与CerbB2＋型相比，差异无统计学意义，肿瘤直径大于3．0cm的比率分别为64．0％和70．6％；Basal-like乳腺癌组织学分级较高，Ⅲ级占56．0％，而CerbB2＋型、ER＋型相对较低，Ⅰ、Ⅱ级分别占82．4％、83．8％（P〈0．01）；同时，三型乳腺癌在腋窝淋巴结转移方面也存在差别，CerbB2＋型与ER＋型的腋窝淋巴结阳性率高于Basal．1ike型，前两型腋窝淋巴结阳性率分别是64．7％、64．9％，而Basal-like型为40．0％（P〈0．05）；Basal．1ike型和CerbB2＋型内脏转移率较高，ER＋型多为局部淋巴结转移和骨转移；在预后方面，Basal．1ike型与CerbB2＋型的5年总生存率低于ER＋型，分别为48．5％、44．1％及83．8％，而三型乳腺癌的5年无瘤生存率差异无统计学意义，分别为42．7％、40．4％及58．3％。结论Basal-like乳腺癌的临床病理特征及预后与CerbB2＋型相似，但是明显差于ER＋型乳腺癌。

Objective To analyze the clinicopathologic characterizations and patients prognosis of basal-like breast cancer. Methods The clinicopathologic characterizations, patient 5 year disease-free survival rate and overall survival rate of 25 basal-like breast cancer patients were compared with 34 CerbB2 overexpressing subtype and 37 ER positive subtype breast cancer patients admitted in our hospital in the same period. Results Patients of basal-like breast cancer accounted for 15.7% of all patients admitted. Compared with CerbB2 over-expressing subtype （ 29.4% ） and ER positive subtype （ 35.1% ）, basal-like breast cancer patients were elder with 56.0% being ≥50 years old （P 〈 0.05 ）. Basal-like subtype breast cancer was larger in tumor size than ER positive subtype （ P 〈 0. 05 ） , 56% of basal-like subtype were of poor-differentiated grade pathologically compared with 18% in CerbB2 overexpression type and 16% in ER positive subtype respectively. Meanwhile, axillary lymph node metastasis was higher in CerbB2 overexpressing and ER positive subtype （64. 7%, 64. 9% ） than that of basal-like subtype （40. 0% ）. Most visceral metastases were found in basal-like and CerbB2 subtype, but there were more local lymph node and bone metastases in ER positive subtype. Five year overall survival rate of CerbB2 overexpressing subtype （48.5%） and basal-like subtype breast cancer patients （44. 1% ） were poorer than that of ER positive subtype（83.8% ）, respectively; However, there was no difference in 5 year disease-free survival rate between the three subtypes （42.7% , 40.4% , 58.3%, respectively）. Conclusions Similar to CerbB2 over-expressing subtype, the clinicopathologic characterization and prognosis in basal-like breast cancer are poorer than that in ER positive subtype.