腋淋巴结无转移的乳腺癌患者雌激素受体检测的预后价值  

Value of estrogen receptor in breast cancer with negative axillary lymph node

作　　者：吴凯南[1] 姚榛祥[1] 涂天喜[1] 吴诚义[1] 竺东长[1] 张震寰[1] 

机构地区：[1]重庆医科大学附属第一医院普外科

出　　处：《中华普通外科杂志》1999年第1期52-53,共2页Chinese Journal of General Surgery

摘　　要：目的探讨雌激素受体（ｅｓｔｒｏｇｅｎｒｅｃｅｐｔｏｒ，ＥＲ）状况对腋淋巴结阴性（以下简称ＮＬ）乳腺癌患者预后的影响。方法对我院１９８５年４月至１９９２年８月手术治疗的１２８例ＮＬ乳腺癌患者和２６６例腋窝淋巴结转移的乳腺癌患者，用免疫组织化学法检测其标本的ＥＲ状况，并对患者进行随访。结果１２８例ＮＬ乳腺癌ＥＲ检测阳性率７１１％，同期腋窝淋巴结转移的乳腺癌２２６例的ＥＲ阳性率为４５５％，二者的差异有非常显著的意义（Ｐ＜００１）。发生转移及复发１９例，ＥＲ阳性和阴性组的复发转移率分别为１２１％和２１６％；５年生存率为９４５％和８３８％（Ｐ＜００５）；１０年生存率为６８２％和６００％（Ｐ＞００５）。１２８例ＮＬ乳腺癌患者中随访１２６例，占９８４％，随访时间６０～１４４个月，平均８０９个月。结论ＮＬ乳腺癌的ＥＲ状况是影响预后的重要因素，ＥＲ阴性组发生复发转移多于阳性组，且易转移至内脏，其５年生存率也明显低于ＥＲ阳性组。故对ＮＬ乳腺癌，当ＥＲ阴性时。Objective To evaluate the prognostic significance of the status of estrogen receptor (ER) of the breast cancer specimen for patients with negative axillary lymphnodes (NL).Methods The ER status was examined by means of immunohistochemistry in 394 breast cancer patients.Results were compared with the status of lymphnods,and the patients were followed up. Results The ER positive rate of 128 NL cancer patients was 71 1% vs. 45 5% in 266 cancer patients with postive axillary lymphnodes ( P <0 01).126 out of 128 NL patients were followed up from 60 to 144 months (average of 80 9 months).Cancer recurrence and remote metastasis was found in 19 cases,with the recurrent rate of 12 1% and 5 year survival rate of 94 5% in those of positive ER vs. 21 6% and 5 year survival rate of 83 8% in that of negative ER,respectively ( P <0 05,each),though the difference of 10 year survival rate failed to reach the level of statistical significance (68 2% vs. 60 0%, P >0 05). Conclusions Breast cancer patients with positive ER are less likely to suffer axillary lymphnode metastasis and tumor recurrence,and aggressive adjuvant chemo ,and /or radiotherapy are strongly recommeded for ER negative patients even there was not primary axillary lymphnode metastasis.

关 键 词：腋淋巴结 受体 雌激素受体 预后 乳腺癌 

分 类 号：R737.9[医药卫生—肿瘤]