39例妊娠相关乳腺癌的病理特征及分子分型

Analysis of clinicopathological features and molecular subtypes in 39 cases of pregnancy associated breast cancer

目的探讨妊娠相关乳腺癌的临床病理特征及分子分型,为妊娠相关乳腺癌的诊治提供依据。方法对39例妊娠相关乳腺癌及同期143例非妊娠相关乳腺癌患者(<45岁)的临床病理资料进行回顾性分析,采用免疫组化技术检测患者手术标本的雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)、Ki-67的表达情况,并对HER-2 2+的标本进行FISH检测,根据结果进行分子分型,对比分析两组患者的临床病理特征及分子分型。结果妊娠相关乳腺癌的病理类型以浸润性导管癌为主,约占84.6%(33/39)。与同期非妊娠相关乳腺癌患者(<45岁)相比,妊娠相关乳腺癌患者临床分期和淋巴结转移率更高,差异均有统计学意义(P<0.05);所占比例Luminal B型较高,Luminal A型较低,差异有统计学意义(P<0.05)。而两组患者的病理类型、肿瘤大小、组织学分级及ER、PR、HER-2、Ki-67表达水平的差异均无统计学意义(P>0.05)。结论妊娠相关乳腺癌在确诊时临床分期晚,淋巴结转移率高,分子分型以Luminal B型为主,恶性程度高,应重视该病的早期诊治。

Objective To investigate the clinicopathological characteristics and molecular subtypes of pregnancy-associatedbreast cancer（PABC） and provide evidence for the diagnosis and treatment of PABC.Methods The clinical andpathological data of 39 cases of PABC and 143 cases of non-PABC（45 years）admitted to our hospital were reviewed.Theexpression of estrogen receptor（ER）,progesterone receptor（PR）,human epidermal growth factor receptor 2（HER-2）and Ki-67 were detected by immunohistochemistry.The HER-2 2＋ specimens were detected by FISH.The molecular subtypes wereperformed according to the results.The clinicopathological features and molecular subtypes were compared between the twogroups.Results The pathological types of PABC were mainly invasive ductal carcinoma,accounting for 84.6%（33/39）.Compared with non-PABC（45 years）patients,the PABC patients had more advance clinical stage and higher lymph nodemetastasis rate（P〈0.05）,and the proportion of Luminal B was higher,while Luminal A type accounted for a lowerproportion;the difference was statistically significant（P〈0.05）.The pathological types,tumor size,histological grade and theexpression levels of ER,PR,HER-2 and Ki-67 in two groups had no significant differences（P〈0.05）.Conclusion PABChad a more advanced clinical stage and higher lymph node metastasis rate at diagnosis,and its molecular subtype was mainlyLuminal B type with great malignancy,and the early diagnosis and treatment of the disease should be emphasized.