乳腺癌分子分型与远处转移时间及部位的分析

The analysis of breast cancer molecular typing for time and location of distant metastasis

目的探讨乳腺癌分子分型与远处转移时间及部位的关系。方法回顾性分析2000年1月至2009年1月693例在我院确诊为乳腺癌的患者,收集并完善所有病例的雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER2)的免疫组化检测结果,追踪了解患者有无远处转移及发生的时间和部位,将发生远处转移的患者依首发转移部位分为内脏转移和非内脏转移两组,分析乳腺癌各分子亚型患者首次远处转移部位和时间的风险分布。结果 129例远处转移的患者中内脏转移78例,非内脏转移51例。HER2过表达型和basal-like型患者内脏转移率高(P=0.01、P=0.001);复发风险函数曲线显示:luminalA型曲线低平,且高峰出现时间较晚,basal-like型第一高峰出现时间早,峰值高。结论乳腺癌分子分型作为患者预后评估的重要工具,在准确评估患者术后远处转移的时间和部位分布方面是TNM分期法的重要补充,有助患者术后随访的个体化筛查。

Objective To find out the risk distribution of breast cancer for time and location of distant metastasis in molecular typing.Methods We studied retrospectively the female patients who were diagnosed as invasive ductal breast cancer in our hospital from January 2000 to January 2009,detected the ER,PR,HER2 expressed in the paraffin sections.The patients with distant metastasis were divided into visceral metastasis and non-visceral metastasis with the first transfer site as standard,for analysing the distribution in molecular typing and the time of the first site of distant metastasis.Results There were 129 patients encountered distant metastasis,including 78 patients with visceral metastasis,and 51 patients with non-visceral metastasis.The rates of visceral metastasis for patients who belonged to HER2 type and basal-like type were higher than that of non-visceral metastasis（P=0.01,P=0.001）.The risk function curve of molecular types showed that,the peak of luminal A type was lowest,delayed,and the basal-like＇s was highest,advanced.Conclusions As an important tool for assessing the prognosis of patients,molecular typing of breast cancer is an important complement for TNM method in accurately assessing the patients of distant metastasis for time and location,and helpful for the individual screening of patients for distant metastasis.