Ki67作为ER＋和(或)PR＋乳腺癌进一步分型指标的研究

Research of Ki67 as index for further classification of ER + and/or PR + breast cancer

目的:探讨Ki67作为Luminal乳腺癌进一步分型中的重要指标的可能性,为以分子分型为基础的乳腺癌个体化治疗选择提供依据。方法:采用免疫组织化学(IHC)检测并将Luminal型乳腺癌分为Luminal A、Luminal B、Luminal-HER23种亚型,回顾性分析717例Luminal型乳腺癌的临床病理学特点及临床治疗情况。结果:(1)3种亚型临床病理学特征及临床治疗方案选择方面具有显著差异(P<0.05)。(2)3种亚型5年无病生存率差异具有显著性(P<0.05)。(3)辅助性放疗能降低Luminal B型患者的复发风险(P<0.05),辅助性化疗能够降低Ki67阳性且存在高危险因素的Luminal型患者的复发风险(P<0.05)。内分泌治疗是Luminal型患者一个有效的治疗手段(P<0.05)。结论:Ki67可成为对Luminal型乳腺癌进一步分型的指标,为临床个体化治疗改善患者预后提供新的视角和依据。

Objective Ki67 may be an important indicator for further classification in Luminal breast cancer, the further classification will provide evidence for the selection of individual therapy basis of molecular classification. Methods Luminal breast cancer was divided into three subtype： Luminal A, Luminal B, and Luminal-HER2 by immunohistochemistry （IHC）, the clinical pathologic characteristics and clinical treatment of 717 cases with Luminal type of breast cancer cases were retrospectively analyzed. Results （ 1 ） The three breast cancer intrinsic subtypes had significant differences in the clinicopathological characteristics and clinical treatment choice. （2）5 years disease-free survival of the three breast cancer intrinsic subtypes were significant differences. （3）Adjunctive radiotherapy could decrease the risk of relapse in Luminal B （P 〈 0.05）. Adjuvant chemotherapies could reduce the relapse for the patients with risk factors and Ki67 positive Luminal breast tumors （P 〈 0.05）. Adjuvant hormone therapy was an effective treatment for Luminal breast cancer （P 〈 0.05）i Conclusion Ki67 may be an indicator for further classificaiion in Luminal breast cancer, provide new visual angle and reference for clinical treatment and improving the prognosis of patients.