改良根治术后的乳腺癌免疫组化3种分子亚型的预后特性研究

Prognostic Characteristics of Three Molecular Subtypes of Breast Cancer Immunohistochemistry after Modified Radical Mastectomy

目的:探讨改良根治术后的乳腺癌免疫组化3种分子亚型的预后特性研究。方法:回顾性分析2018年1月~2020年1月在某院行改良根治术的90例乳腺癌患者的临床资料,均对病理组织行免疫组化法检查,确定人表皮生长因子受体2(HER-2)、雌激素受体(ER)、孕激素受体(PR)、Ki67等的表达,通过肿瘤细胞ER、PR、HER-2的表达将乳腺癌分为3种分子亚型:Luminal型(ER和/或PR阳性)、HER-2过表达型(HER-2阳性,ER及PR阴性)、三阴型(ER、PR、HER-2均为阴性),对比3种分型的病理特征、病理预后。结果:90例患者中,Luminal型57例(63.33%),HER-2过表达型11例(12.22%),三阴型22例(24.44%);90例患者中,5级有11例、4级有34例、3级有25例、2级有17例、1级有3例,有效率为77.78%(70/90);Luminal型有效率为75.44%(43/57),HER-2过表达型的有效率为72.73%(8/11),三阴型的有效率为86.36%(19/22),三阴型的有效率最高,差异有统计学意义(P<0.05);不同分型中肿瘤大小、是否绝经相比,差异无统计学意义(P>0.05),而年龄、腋窝阳性淋巴结数、临床分期有明显差异(P<0.05);多因素预后分析显示,淋巴结转移和分子分型是重要预后因素(P<0.05)。结论:改良根治术后的乳腺癌免疫组化3种分子亚型中,三阴型的有效率最高,预后淋巴结转移和分子分型密切相关。

Objective:To investigate the prognostic characteristics of three molecular subtypes of breast cancer immunohistochemistry after modified radical mastectomy.Methods:A retrospective analysis of the clinical data of 90 cases of breast cancer patients undergoing modified radical surgery in a hospital from January 2018 to January 2020 were conducted.All pathological tissue was examed by immunohistochemical method to determine the expression of human epidermal growth factor receptor 2(HER-2),estrogen receptor(ER)and progesterone receptor(PR)and Ki67,and breast cancer was divided into three molecular subtypes by expression of tumor cell ER,PR,HER-2 which was including Luminal type(ER and/or PR positive),HER-2 overexpression type(HER-2 positive,ER and PR negative),and triple negative type(all ER,PR,and HER-2 negative),then the efficacy pathological features and prognosis of the three types were compared.Results:Among the 90 patients,57 cases were Luminal type(63.33%),11 cases were HER-2 overexpression type(12.22%),and 22 cases were tri-negative type(24.44%).Among the 90 patients,there was 11 cases in Grade 5,34 cases in Grade 4,25 cases in Grade 3,17 cases in Grade 2,3 cases in Grade 1,and the effective rate was 77.78%(70/90).The effective rate of Luminal type was 75.44%(43/57),that of HER-2 type was 72.73%(8/11),and that of tri-negative type was 86.36%(19/22).The tri-negative type effective rate was the highest,with statistically significant difference(P<0.05).There was no statistically significant difference in tumor size and whether menopause(P>0.05),but there was significant difference in age,number of positive lymph nodes in axillary fossa and pathological stage(P<0.05).Multivariate prognostic analysis revealed that lymph node metastasis and molecular typing were important prognostic factors(P<0.05).Conclusion:Among the three molecular subtypes of breast cancer immunohistochemistry after modified radical mastectomy,the effective rate of the triple negative types is the highest,and the prognostic lymph node metastasis and molecular typing are closely related.