乳腺癌分子分型与腋窝淋巴结转移相关性分析  

Correlation between molecular subtype and axillary lymph node metastasis of breast cancer

作　　者：谢文秀[1] 杨俊兰[2] 焦顺昌[2] 戴广海[2] 李自健[3] 游俊浩[2] 

机构地区：[1]海军总医院特需医疗部,北京100048 [2]解放军总医院肿瘤科,北京100853 [3]武汉161医院肿瘤科,武汉430010

出　　处：《军医进修学院学报》2011年第7期708-711,共4页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的分析乳腺癌分子分型与腋窝淋巴结转移的相关性。方法 2000年1月-2009年12月在解放军总医院就诊的Ⅰ-Ⅲ期乳腺癌患者共773例,依据雌激素受体(ER)、孕激素受体(PR)、表皮生长因子受体-2(HER-2)的表达将其近似划分为Luminal A型(ER+和/或PR+,HER2-)、Luminal B1型(ER+,PR+,HER-2+)、Luminal B2型(ER+或PR+,HER-2+)、HER-2型(ER-,PR-,HER-2+)和Basal型(ER-,PR-,HER-2-)5个分子亚型,对比腋窝淋巴结转移阳性率的差异。对影响腋窝淋巴结转移的因素进行Logistic回归分析。结果 Luminal B1型腋窝淋巴结转移率最高,HER-2型、Luminal B2型次之,再次为Basal型,Luminal A型最低,各分子亚型的腋窝淋巴结转移率有显著差异(P<0.05);Logistic回归分析提示是否为luminal B1型、Luminal A型、年龄、肿瘤直径、组织学分级以及是否为黏液癌或早期浸润癌是影响腋窝淋巴结转移的独立因素(P<0.05)。结论表达HER-2的Luminal B1型、HER-2型及Luminal B2型具有高腋窝淋巴结转移率的特点,分子分型与腋窝淋巴结转移相关。Objective To analyze the correlation between molecular subtypes and axi/lary lymph node（ALN） metastasis of breast cancer. Methods A total of 773 patients with breast cancer at 1-3 stages admitted to Chinese PLA General Hospital from January 2000 to December 2009 were enrolled in this study. Breast cancer were divided into luminal A molecular subtype（ER＋ and/or PR＋, HER2-）, luminal B 1 molecular subtype（ER＋, PR＋, HER2＋）, luminal B2 molecular subtype（ER＋ or PR＋, HER-2＋）, HER-2 molecular subtype（ER-, PR-, HER-2＋） and basal molecular subtype（ER-, PR-, HER-2-） according to the expression of ER, PR and HER-2. Differences in positive axillary ALN metastasis of 5 molecular subtypes of breast caner were analyzed. Logistic regression analysis was performed for the factors influencing axillary ALN metastasis of breast cancer. Results The axillary ALN metastasis rate was the highest for luminal B1 molecular subtype of breast cancer followed by HER-2 molecular subtype, luminal B2 molecular subtype, basal molecular subtype, and luminal A molecular subtype. A significant difference was observed in axillary ALN metastasis rate for different molecular subtypes of breast cancer（P〈0.05）. Logistic regression analysis showed that luminal B 1 molecular subtype, luminal A molecular subtype, age of patients, tumor size, histological grade, mucoid adenocarcinoma, and early invasive carcinoma are the independent factors for axillary ALN metastasis of breast cancer. Conclusion The axillary ALN metastasis rate is high for luminal B 1 molecular subtype, HER-2 molecular subtype, and Luminal B2 molecular subtype of breast cancer expressing HER-2. The molecular subtypes of breast cancer are related with the axillary ALN metastasis of breast cancer.

关 键 词：乳腺肿瘤 分子分型 腋窝淋巴结 

分 类 号：R737.9[医药卫生—肿瘤]