腋窝淋巴结阴性浸润性乳腺癌的分子分型及预后观察

Different molecular classification in the distribution of axillary lymph node negative invasive breast cancer and prognosis is seen

目的探讨腋窝淋巴结阴性浸润性乳腺癌患者的分子分型及其预后情况。方法回顾性分析2006年12月至2009年6月间180例腋窝淋巴结阴性浸润性乳腺癌的临床病理资料,并按照雌激素受体(ER)、孕激素受体(PR)及人类表皮生长因子受体-2(HER-2)的检测结果将其分为管腔上皮(Luminal)型、基底样(Basal-like)型及HER-2过表达(over-expression)型,观察不同分型乳腺癌在不同年龄、肿瘤大小及分期中的表达及预后情况。结果 180例腋窝淋巴结阴性浸润性乳腺癌患者中,Luminal型、Basal-like型、HER-2过表达型分别占54.4%(98/180)、27.8%(50/180)和17.8%(32/180)。Luminal型、Basal-like型、HER-2过表达型在不同年龄、肿瘤大小及临床分期中的表达差异无统计学意义(P>0.05)。Basal-like型患者术后36和60个月的转移率分别为14.0%和36.0%,高于Luminal型的3.1%、20.4%及HER-2过表达型的6.3%、21.9%,差异有统计学意义(P<0.05)。Basal-like型患者术后60个月的死亡率为24.0%,高于Luminal型(10.2%)及HER-2过表达型(15.6%),HER-2过表达型患者术后60个月的死亡率高于Luminal型,差异有统计学意义(P<0.05)。结论腋窝淋巴结阴性浸润性乳腺癌的分子分型以Lumina1型最为常见,Basal-like型与HER-2过表达型构成比较低,其中Basal-like型患者预后较差,其次为HER-2过表达型患者。

Objective To explore the expression of axillary lymph node-negative type of invasive breast cancer molecules and analyze prognosis. Methods A total of clinical pathological information of 180 cases with axillary lymph node negative invasive breast cancer were retrospectively analyzed, and according to the estrogen receptor （ER）, progesterone receptor （PR） , and human epidermal growth factor receptor 2 （ HER2 ） test results, patients were divided into the luminal epithelium （ Luminal ）, basaloid （ Basal hominins-like） and HER2 expression （over-expression） type, observed the expression of three type in different age, tumor size and staging patients with breast cancer and prognosis of them. Results （ 1 ） Luminal, Bas- al-like, HER-2 overexpression type in 180 cases of invasive breast cancer with axillary lymph node-negative was 54.4% （98/180）, 27.8% （50/180）, 17.8% （32/180）, respectively; （2）The expression of Lu- minal, Basal-like, HER-2 overexpression type in different age, tumor size and clinical staging patients was not statistically difference （ P 〉 O. 05 ） ; （3） After 36 months, 60 months, metastasis rates of basal-like type were 14. 0%, 36. 0%, higher than Luminal-type （ 3.1% , 20. 4% ） and HER-2 over-expression type （6. 3% , 21.9% ） with statistically difference （P 〈 0.05 ） ; （4）After 60 mo, mortality of Basal-like type was 24. 0%, higher than Luminal-type （ 10. 2% ） and HER-2 over-expression type （ 15.6% ） ; Mortality of HER-2 overexpression was higher than Luminal type with statistically difference （ P 〈 0. 05 ）. Conclusion Luminal is the most common type in Axillary lymph node-negative invasive breast cancer molecular typing. Patients with Basal-like type have poor prognosis, followed by HER-2 overexpression type.