21基因低复发风险评分与早期乳腺癌远处转移的相关性研究

Relationship between low recurrence risk score of 21 gene and distant metastasis of early breast cancer

目的探讨乳腺癌21基因低复发风险评分的激素受体阳性、人表皮生长因子受体-2(HER-2)阴性及淋巴结阴性早期乳腺癌患者发生远处转移的相关预后影响因素。方法回顾性分析2014年5月至2018年2月河南省人民医院收治的乳腺癌21基因低复发风险评分的140例激素受体阳性、HER-2阴性及淋巴结阴性早期乳腺癌患者的临床病理资料。根据乳腺癌21基因检测复发风险值(RS)分值将患者为两组:RS 0~10分组,共74例(52.9%);RS 11~18分组,共66例(47.1%)。比较两组患者肿瘤大小、肿瘤病理分级、Ki-67指数、淋巴血管侵犯等临床病理特征,治疗及远处转移预后情况。结果RS 0~10组和RS 11~18组患者中位随访时间分别为36、39个月,共5例患者发生远处转移(RS 0~10组1例,RS 11~18组4例)。两组患者整体远处转移率为3.6%,两组中在<40岁时诊断为乳腺癌的患者远处转移发生率较≥40岁时诊断为乳腺癌的患者远处转移发生率高,其中<40岁患者远处转移率为2.1%,≥40岁患者远处转移率为1.4%。结论21基因低复发风险评分的激素受体阳性、HER-2阴性、淋巴结阴性早期乳腺癌患者术后发生远处转移率低,发病年龄<40岁可能是影响其发生远处转移的重要因素。

Objective To investigate the prognostic factors associated with distant metastasis in early breast cancer patients with low recurrence risk score of breast cancer 21 gene detection, hormone receptor positive, HER-2 negative and lymph node negative. Methods The clinical and pathological data of 140 patients with hormone receptor-positive, HER-2-negative and lymph node-negative early breast cancer treated in Henan People’s Hospital from May 2014 to February 2018 were retrospectively analyzed. According to recurrence score (RS) score, the patients were divided into two groups, 74 cases (52.9%) in RS 0-10 group and 66 cases (47.1%) in RS 11-18 group. The clinical and pathological characteristics, treatment and prognosis of distant metastasis, such as tumor size, pathological grade, Ki-67 index and lymphatic vascular invasion were compared between the two groups. Results The median follow-up time of RS 0-10 group and RS 11-18 group was 36 months and 39 months, respectively. There were 5 patients with distant metastasis (1 case in RS 0-10 group and 4 cases in RS 11-18 group). The overall distant metastasis rate of the two groups was 3.6%. The incidence of distant metastasis in breast cancer patients diagnosed at < 40 years old was higher than that in breast cancer patients diagnosed at≥40 years old. The distant metastasis rate of patients diagnosed aged < 40 years old was 2.1%, and that of patients diagnosed aged ≥ 40 years old was 1.4%. Conclusions Hormone receptor-positive, HER-2-negative and lymph node-negative early breast cancer patients with low recurrence risk score of 21 gene have a low rate of distant metastasis after operation. Diagnosed age < 40 may be an important factor affecting distant metastasis.