脉管癌栓与不同分子分型乳腺癌术后复发的关系

Relationship between vascular tumor thrombus and postoperative recurrence of different molecular typing of breast cancer

目的探讨脉管癌栓与不同分子分型乳腺癌术后复发的关系。方法收集我院乳腺外科2016年1月1日~2017年6月1日经病理学检查确诊为浸润性乳腺癌患者196例的临床资料。根据脉管癌栓的状态分为脉管癌栓阳性组和脉管癌栓阴性组。分析患者临床病理特征的差异并探究不同分子分型患者的5年复发情况。结果单因素χ2检验显示:脉管癌栓阳性表达与年龄、分子分型、肿瘤长径、淋巴结转移情况、组织学分级、pTNM分期有关,差异有统计学意义(P<0.05)。单因素Kaplan-Meier分析显示:年龄、淋巴结转移情况、pTNM分期、脉管癌栓状态、分子分型与患者的复发有关,差异有统计学意义(P<0.05);Cox回归多因素分析显示:年龄、脉管癌栓状态、分子分型是影响乳腺癌患者复发的的独立因素(P<0.05);在Luminal B型、三阴型乳腺癌中脉管癌栓阳性与乳腺癌的复发相关,差异有统计学意义(P<0.05)。结论脉管癌栓阳性、分子分型和年龄是乳腺癌复发的独立危险因素,其中脉管癌栓为阳性的Luminal B型或三阴型的年轻乳腺癌患者更易复发,需要缩短复查周期,为精准个体化治疗提供一定依据。

Objective To investigate the relationship between vascular tumor thrombus and postoperative recurrence of different molecular tying of breast cancer.Methods 196 patients with invasive breast cancer confirmed by pathological examination from Jan 1,2016 to Jun 1,2017 in the department of breast surgery of our hospital were collected.According to the status of vascular tumor thrombus,they were divided into vascular tumor thrombus positive group and vascular tumor thrombus negative group.The differences of clinicopathological characteristics were analyzed and the 5-year recurrence of patients with different molecular typing were explored.Results Positive vascular tumor thrombus was correlated with age,molecular typing,tumor length and diameter,lymph node metastasis,histological grade and p TNM stage,the difference was statistically significant(P<0.05).Univariate Kaplan Meier analysis showed that age,lymph node metastasis,p TNM stage,vascular tumor thrombus status,molecular typing were correlated with the recurrence of patients,the difference was statistically significant(P<0.05);Cox regression multi factor analysis showed that age,vascular tumor thrombus status and molecular typing were independent factors affecting the recurrence of breast cancer patients(P<0.05),the difference was statistically significant;In luminal B and triple negative breast cancer,the positive vascular tumor thrombus was correlated with the recurrence of breast cancer,the difference was statistically significant(P<0.05).Conclusion Positive vascular tumor thrombus,molecular typing and age are independent risk factors for recurrence of breast cancer.Young breast cancer patients with luminal B or triple negative vascular tumor thrombus positive are more likely to relapse,and need to shorten the review cycle,so as to provide a certain basis for accurate individualized treatment.