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华西医学  2011 

乳腺癌不同分子亚型腋窝淋巴结转移的状态及预后分析

, PP. 971-974

Keywords: 乳腺肿瘤,分子亚型,淋巴结转移,预后

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Abstract:

【】 目的 探讨乳腺癌不同分子亚型腋窝淋巴结转移的状态及预后分析。 方法 对2005年1月-2007年12月收治的125例乳腺癌患者进行分子分型,对腋窝淋巴结转移状态进行分析并结合随访结果进行预后分析。 结果 LuminalA型63例,16例淋巴结转移,转移率为25.4%;LuminalB型19例,7例淋巴结转移,转移率为36.8%;HER-2过表达型26例,11例淋巴结转移,转移率为42.3%;Basal-like型17例,9例淋巴结转移,转移率为52.9%。其中LuminalA型淋巴结转移率与Basal-like型比较差异有统计学意义(P0.05)。运用χ2检验各分子亚型在肿瘤大小的差异无统计学意义(P>0.05)。经过2~5年随访,8例患者出现局部复发或远处转移,其中LuminalB型2例,HER-2过表达型5例,Basal-like型1例。8例中有3例因肝转移死亡,另5例接受治疗现仍生存。 结论 乳腺癌的分子分型可作为腋窝淋巴结转移的预测指标,HER-2过表达型和Basal-like型预后较差,将为今后制定乳腺癌个体化治疗提供重要依据。【Abstract】 Objective Toanalyzetheaxillarylymphnodesmetastasisofvariousbreastcancermolecularsubtypesanditsprognosis. Methods Molecularsubtypesof125casesofoperablebreastcancerdiagnosedandtreatedbetweenJanuary2005andDecember2007werecategorized,andtheaxillarylymphnodesmetastasisofthesetypeswasanalyzed.Atthesametime,weanalyzeditsprognosisstatuswiththeresultsofthefollow-up. Results Amongthe125cases,therewere63luminalAcasesinwhich16(25.4%)werefoundtobeaxillarylymphnodesmetastasis.Amongthe19luminalBcases,therewere7(36.8%)axillarylymphnodesmetastases.Therewere11cases(42.3%)ofaxillarylymphnodesmetastasisinthe26casesofHER-2(+)subtype.Inthe17casesofbasal-likesubtye,9(52.9%)wereaxillarylymphnodesmetastases.Asfortheaxillarylymphnodesmetastaticrate,onlybasal-likesubtypewashigherthanluminalAsubtypewithastatisticallysignificantdifference(P0.05).Themolecularsubtypesdidnotdifferintumorsize(P>0.05)accordingtotheresultofchi-squaretest.Duringthe2to5-yearfollow-up,8ofthe125patientswerefoundtohavelocaltumorrecurrenceordistantmetastaticdisease,whichincluded2luminalBcases,5HER-2(+)subtypecases,and1basal-likesubtypecase.Inthose8patients,3diedoflivermetastasesand5survivedandarestillacceptingtreatmentnow. Conclusions Molecularsubtypingcanprovideimportantinformationofaxillarylymphnodesmetastaticstatus.HER-2over-expressionandbasal-likesubtypehaveapoorprognosis,whichisanimportantbasisforindividualtreatmentofbreastcancerinthefuture.

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