雌激素孕激素受体阳性与雌激素受体阳性孕激素受体阴性乳腺癌的临床研究

Clinical analysis of ER^+ PR^+ and ER^+ PR^- in breast cancer

目的探讨雌激素孕激素受体阳性与雌激素受体(ER)阳性孕激素受体(PR)阴性乳腺癌的临床病理特征及预后因素分析。方法收集2012年1月至2015年12月山东省肿瘤医院收治的398例女性乳腺癌患者的临床资料,分析病理学特征。应用χ2检验比较不同组的差异;应用COX回归模型分析疾病进展相关因素。结果低ER水平(HR 5.59,95%CI:2.42~12.95,P<0.001)、低PR水平(HR 0.19,95%CI:0.04~0.90,P<0.05)和高Ki-67增殖指数(HR 5.84,95%CI:1.91~17.85,P<0.05)的患者复发率更高。ER+/PR+患者与ER+/PR-患者在肿瘤体积(P<0.001)、病理分期(P<0.001)、Ki-67水平(≥20%)(P<0.001)、Her-2阳性表达(P<0.05)等方面比较,差异有统计学意义。结论 ER+/PR-乳腺肿瘤比ER+/PR+乳腺肿瘤具有更强的侵袭性。

Objective This study aimed to analyze the clinical and pathological characteristics, and the prognosis between estrogen receptor （ER） ＋/progesterone receptor （PR） ＋ and ER ＋/PR - subtype breast cancer. Methods We analyzed clinieopathological and immunohistochemical features of 398 breast cancer pa- tients receiving surgery in our hospital from January 2012 to December 2015 retrospectively. The differences be- tween different groups were compared by chi-square test. Progress free survival was followed up, and COX logis- tic regression was applied to estimate the factors associated with high risk of progression. Results Among all women with breast cancer, recurrence was higher with low ER levels （HR： 5. 59, 95% CI： 2.42 - 12. 95, P 〈 0. 001 ）, low PR levels （HR： O. 19, 95% CI： O. 04 ＋0. 90, P =0. 036）, and high Ki-67 proliferation index （HR： 5.84, 95% CI： 1.91 ＋ 17.85, P =0. 002）. We found that the tumors were larger in patients with ER＋/ PR-than those with ER＋/PR＋ （P 〈 0. 001 ）, and pathological staging II/III were more frequently found in ER ＋/PR- tumors （P 〈 0. 001 ）. The difference was also statistically significant in Ki-67 level （/〉20% ） （P 〈 0. 001 ） and HER-2 positive expression （ P 〈 0.05 ） between ER ＋/PR - patients and ER ＋/PR ＋ patients. Con- clusions PR- breast tumors were more likely to have an aggressive phenotype than PR ＋ breast tumors by com- paring the ER ＊/PR ＋ tumors with ER ＋/PR tumors in clinicopathological and immunohistochemical dates.