维吾尔族乳腺癌各分子亚型的临床特点及生存分析
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摘要
目的:探讨153例维吾尔族乳腺癌各分子亚型的病理特点,并分析其生存预后状况。方法:回顾性分析2004年1月～2005年1月新疆医科大学附属肿瘤医院收治的153例维吾尔族乳腺癌患者各分子亚型的临床病理资料,在免疫组织化学技术的基础上,把乳腺癌分为4种分子亚型:Luminal A型[ER(+)和/或PR(+)且HER-2(-)],Luminal B型[ER(+)和/或PR(+)且HER-2(+)],HER-2过表达型[ER(-)、PR(-)且HER-2(+)]和Basal-like型[ER(-)、PR(-)且HER-2(-)],并对患者进行随访观察,生存率采用Kaplan-Meier的方法计算。结果:本研究共153例,其中Luminal A型占58.2%(89/153),Luminal B型占7.2%(11/153), HER-2过表达型占12.4%(19/153),Basal-like型占22.2%(34/153)。各分子亚型患者在年龄、绝经情况、乳腺癌家族史、肿瘤大小、淋巴结状况、TNM分期、病理类型方面采用χ2检验或Fisher确切概率检验无统计学差异。全组有完整随访资料者共153例,中位随访时间45个月。各分子亚型患者的DFS和OS采用Kaplan-Meier法分析有统计学差异, Log-Rank检验后得出:Luminal A型的DFS高于Basal-like型,而OS高于HER-2过表达型和Basal-like型,且有统计学差异(P均<0.05)。结论:维吾尔族乳腺癌的分子分型有望为个体化治疗提供重要依据,且对维吾尔族乳腺癌患者生存预后的判断具有重要临床意义。
Objective To study the clinical pathological features and prognostic status of molecular subtyping of breast cancer in 153 cases of Uygur patients. Methods The clinical data of 153 patients with Uygur breast cancer, admitted to Xinjiang Medical University Cancer Institute & Hospital from Janury 2004 to Janury 2005, were collected and analyzed retrospectively. Molecular subtypes, based on immunohistochemistry staining results, were categorized as follows: Luminal A [ER(+) or PR(+)/HER-2(-)], Luminal B [ER(+) or PR(+)/HER-2 (+)], HER-2(+) subtype [ER(-), PR(-)/HER-2 (+)], and Basal-like subtype[ER(-), PR(-)/HER-2(-)].. Survival rate was calculated by applying Kaplan-Meier. Results Among the 153 cases, 89 cases (58.2%) were Luminal A subtype, 11(7.2%) were Luminal B subtype, 19(12.4%) were HER-2(+) subtype, and 34(22.2%) were Basal-like subtype. There are not significantly different with repect to age, menopausal status, family history, tumor size, node status, TNM stage, and histological type in different subtypes. Complete follow up data were obtained in 153 cases , the median follow-up time was 45 months, Distant metastatic rates were not significantly different between HER-2(+)subtype and Basal-like subtype (P<0.050). Kaplan-Meier analysis showed DFS and OS of 4 subtypes were different statistically, Log-Rank test showed there was higher over survival (OS) in Luminal A subtype than those in HER-2(+) subtype and Basal-like subtype, and higher disease free surivival (DFS) in Luminal A subtype than that in Basal-like subtype, (P<0.050). Conclusions Molecular subtyping of Uygur breast cancer may provide the important basis for individualized treatment of uygur breast cancer. and could be of clinical significance for survival and prognosis of Uygur breast cancer patients.
Objective To study the clinical pathological features and prognostic status of molecular subtyping of breast cancer in 153 cases of Uygur patients. Methods The clinical data of 153 patients with Uygur breast cancer, admitted to Xinjiang Medical University Cancer Institute & Hospital from Janury 2004 to Janury 2005, were collected and analyzed retrospectively. Molecular subtypes, based on immunohistochemistry staining results, were categorized as follows: Luminal A [ER(+) or PR(+)/HER-2(-)], Luminal B [ER(+) or PR(+)/HER-2 (+)], HER-2(+) subtype [ER(-), PR(-)/HER-2 (+)], and Basal-like subtype[ER(-), PR(-)/HER-2(-)].. Survival rate was calculated by applying Kaplan-Meier. Results Among the 153 cases, 89 cases (58.2%) were Luminal A subtype, 11(7.2%) were Luminal B subtype, 19(12.4%) were HER-2(+) subtype, and 34(22.2%) were Basal-like subtype. There are not significantly different with repect to age, menopausal status, family history, tumor size, node status, TNM stage, and histological type in different subtypes. Complete follow up data were obtained in 153 cases , the median follow-up time was 45 months, Distant metastatic rates were not significantly different between HER-2(+)subtype and Basal-like subtype (P<0.050). Kaplan-Meier analysis showed DFS and OS of 4 subtypes were different statistically, Log-Rank test showed there was higher over survival (OS) in Luminal A subtype than those in HER-2(+) subtype and Basal-like subtype, and higher disease free surivival (DFS) in Luminal A subtype than that in Basal-like subtype, (P<0.050). Conclusions Molecular subtyping of Uygur breast cancer may provide the important basis for individualized treatment of uygur breast cancer. and could be of clinical significance for survival and prognosis of Uygur breast cancer patients.
引文
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[19]陈莉颖,陈红风,付娜,叶媚娜, 218例不同分子亚型浸润性乳腺癌患者的临床特征[J],现代肿瘤学,2007,15(8):1094-1097.
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[21] Smith I, Procter M, Gelber RD, et al. 2-year follow-up of trastuzumab after adjuvant chemo-therapy in HER-positive breast cancer: a randomized controlled trial[J]. Lancet, 2007,369:29-36.
[22] Romond EH, Perez EA, Bryant J, et al. Trastuzumab plus adjuvant chemotherapy for operable HER-2-positive breast cancer[J]. N Engl J Med,2005,353:1673-1684.
[23] Adebamowo CA, Famooto A, Ogundiran TO, et al. Immunohistochemical and moleculear subtypes of breast cancer in Nigeria[J]. Breast Cancer Res Treat, 2008,110:183-188.
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[25] Haffty BG, Yang Q, Reiss M, etal. Locoregional relapse and distant metastasis in conesrvatively managed triple negative early-stage breast cancer[J]. ClinOncol, 2006, 24:5652-5657.
[26]王晓稼,邵喜英.乳腺癌分子标志和分子分型[J].医学分子生物学杂志,2008,5:177-180.
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