HER-2阴性LuminalB型乳腺癌的临床病理特征研究

Research on the Pathological and Clinical Features of HER- 2- negative- Luminal- B Type Breast Cancer

目的探讨HER-2阴性Luminal B型乳腺癌3种亚型的临床病理特征的差别并与Luminal A型乳腺癌进行比较,探索能否将3种亚型中的一部分乳腺癌独立出来重新归为Luminal A型乳腺癌。方法回顾性分析126例HER-2阴性Luminal B型乳腺癌患者,并将其分为3组:组1为PR<20%且Ki-67<14%,组2为Ki-67≥14%且PR≥20%,组3为PR<20%且Ki-67≥14%,分析各组间临床病理资料的差异,并分别与Luminal A型乳腺癌进行比较。结果 HER-2阴性Luminal B型乳腺癌的3个亚组中,肿块直径组1与组3比较差异有统计学意义(P=0.040),组1与组2、组2与组3间比较差异无统计学意义(P>0.05);腋窝淋巴结转移组1与组2比较差异有统计学意义(P<0.05),组1与组3、组2与组3间差异无统计学意义(P>0.05);3个亚组在组织学分级及绝经状态方面差异互无统计学意义(P>0.05);发病年龄组1与组2、组1与组3差异有统计学意义(P<0.05),组2与组3差异无统计学意义(P>0.05);组1与组2在组织类型方面差异有统计学意义(P<0.05),组1与组3、组2与组3在组织类型方面差异无统计学意义(P>0.05);将Luminal A型乳腺癌与组1、组2、组3比较,Luminal A型乳腺癌与组1的临床病理特征差异无统计学意义,而与组2、组3差异有统计学意义。结论 Luminal B型中的HER-2阴性Luminal B型乳腺癌可分为3个亚组,它们在临床病理方面存在着一定的差异,且组1与Luminal A型乳腺癌临床病理特征差异无统计学意义,或许能将组1重新归为Luminal A型乳腺癌,但需进一步前瞻性研究来证实。

Objective To explore the pathological and clinical features difference of patients with HER - 2 - negative - Luminal - B type breast cancer. Methods Totally 126 patients with HER - 2 - negative - Luminal - B type breast cancer patients were divided into 3 groups, and were analyzed retrospectively. In the first group, PR was lower than 20% and Ki - 67 was lower than 14%. In the second group, PR was higher or equal to 20% and Ki -67 was higher than or equal to 14%. In the third group, PR was lower than 20% and Ki - 67 was higher than or equal to 14%. We collected clinical and pathology data, and analyzed difference of HER - negative - Luminal - B type breast cancer, and then compared with Luminal - A Type. Results Among the three subtypes of HER - 2 - negative - Luminal - B type breast cancer, the difference of tumer size brtween group 1 and group 3 was significant, the other was not significant. Compared with group 2, the group 1 was statistically significant of lymphatic metastasis（P 〈 0. 05 ） , the diffrence of group 1 with group 3 and guoup 2 with group 3 was not significant（P 〉 0. 05） , the pathological grade was not statistically significant among the 3 groups（P 〉 0. 05） , the difference of menopause among three groups was not significant（P 〉 0.05）. Compared with group 2, the group 1 was statistically signifi- cant of pathological pattern（ P 〈 0.05 ） , the difference among groupl with group 2 ang group 2 with group3 was not significant（ P 〉 0.05 ）, the difference of age between group 1 and group 2, while between group 1 ang group 3 was statistically significant （P 〈 O. 05） , among group 2 with group 3 was not significant（P 〉 0.05 ）. The difference of pathological and clinical features between Luminal - A type breast cancer an group 1 were not significant, but comapred with group 2 and group 3, the Luminal - A type breast cancer was statistically signif- icant of pathological and clinical features. Conclusion According to PR and Ki - 67, current HER - 2 - negative - Luminal - B type breast cancer can be divided into three different subtypes, which has different pathological and clinical features and the difference of patho- logical and clinical features between Luminal - A type breast cancer an group 1 were not significant that may redefined the group 1 as Lu- minal- A type breast cancer,but needs further study to demonstrate it.