改良根治术后腋窝淋巴结阳性乳腺癌放疗效果与ER、PR及HER2相关性分析  

Correlation analysis of ER, PR, HER2 and radiotherapy effect in node positive breast cancer treated with modified radical mastectomy

作　　者：谢源福[1] 吴秀萍[2] 卓延红[1] 林坤花[1] 李艺江[1] 陈贵平[1] 杨乐艺[2] 吴雄[2] 

机构地区：[1]福建医科大学附属漳州市医院肿瘤放疗科,漳州363000 [2]福建医科大学附属漳州市医院乳腺外科,漳州363000

出　　处：《国际肿瘤学杂志》2014年第1期66-69,共4页Journal of International Oncology

摘　　要：目的 探讨改良根治术后腋窝淋巴结阳性乳腺癌放疗效果与雌激素受体（ER）、孕激素受体（PR）及人类表皮生长因子受体2（HER2）的相关性.方法 选取福建医科大学附属漳州市医院2008年1月至2013年1月乳腺外科收治的进行改良根治术的腋窝淋巴结阳性的乳腺癌患者350例,其中216例接受了放疗,134例未接受放疗,根据ER、PR及HER2的免疫组织化学结果,将所有患者分为三阴性乳腺癌（ER-/PR-/HER2-）、HER2阳性（ER-/PR-/HER2＋）、Luminal B（ER ＋/PR＋/HER2＋）及Luminal A（ER ＋/PR ＋/HER2-）4组,比较放疗对4组患者局部复发率、远处转移率和无瘤生存率的影响.结果 中位随访48个月,放疗降低了三阴性乳腺癌、HER2阳性、Luminal B及Luminal A 4组患者的局部复发率（x2=6.23,P=0.01;x2=8.02,P=0.00;x2=15.43,P=0.00;x2 =4.47,P=0.03）,且前3组放疗患者的远处转移率（x2=4.18,P=0.04;x2 =6.35,P=0.01;x2=43.31,P=0.00）和无瘤生存率（x2=9.78,P=0.00;x2=10.83,P=0.00;x2=16.95,P=0.00）相对于未放疗患者差异具有统计学意义.但放疗对Luminal A组患者的远处转移率和无瘤生存率无影响（P＞0.05）.结论 不同的ER、PR和HER2状态对于改良根治术后腋窝淋巴结阳性乳腺癌患者的放疗结果具有一定影响.Objective To explore the relationship between the radiotherapy effect of axillary lymph node positive breast cancer patient after modified radical mastectomy and estrogen receptor （ER）,progesterone receptor （PR） and human epidermal growth factor receptor 2 （HER2）.Methods From January 2008 to January 2013,350 axillary lymph nodes positive breast cancer patients after modified radical mastectomy in Breast Surgery Department of Zhangzhou Hospital Affiliated to Fujian Medical University were studied.Among them 216 cases received radiotherapy,134 patients did not receive radiotherapy.According to the ER,PR and HER2 immunohistochemistry results,all the patients were divided into triple negative breast cancer （ER-/PR-/HER2-）,HER2 positive group （ER-/PR-/HER2 ＋）,Luminal B group （ER＋/PR＋/HER2＋） and Luminal A （ER＋/PR＋/HER2-） group.The local recurrence rate,distant metastasis rate and disease-free survival rate of 4 groups were compared.Results The median follow up time was 48 months,radiotherapy decreased the local recurrence rates of triple negative breast cancer group,HER2 positive group,Luminal B group and Luminal A group （x2 =6.23,P =0.01 ; x2 =8.02,P =0.00 ; x2 =15.43,P =0.00; x2 =4.47,P =0.03）.Compared with patients who did not receive radiotherapy,the distant metastasis rates （x2 =4.18,P =0.04; x2 =6.35,P =0.014 ; x2 =43.31,P =0.00） and the disease-free survival rates （x2 =9.78,P =0.00 ; x2 =10.83,P =0.00 ; x2 =16.95,P =0.00） of the first three groups in patients received radiotherapy showed marked difference.However,radiotherapy had no effect on the distant metastasis rate and disease-free survival rate （P ＞ 0.05）.Conclusion The different states of ER,PR and HER2 relate tightly to the radiotherapy effect of axillary lymph nodes positive breast cancer patients treated with modified radical mastectomy.

关 键 词：受体 雌激素 受体 孕激素 受体 表皮生长因子 乳腺癌改良根治术 

分 类 号：R737.9[医药卫生—肿瘤]