无腋淋巴结转移乳腺癌患者孕激素受体检测的预后价值  

Prognostic value of progesterone receptor examination in breast cancer patients with negative axillary lymph nodes

作　　者：吴凯南[1] 吴诚义[1] 竺东长[1] 张震寰[1] 孔令泉[1] 

机构地区：[1]重庆医科大学附属第一医院外科,400016

出　　处：《中华外科杂志》2001年第5期344-346,共3页Chinese Journal of Surgery

摘　　要：目的　探讨孕激素受体 (PR)水平对腋淋巴结阴性 (NL)乳腺癌患者预后的影响。方法对手术治疗的 12 8例NL和 2 6 6例腋淋巴结转移 (PL)的乳腺癌患者 ,用免疫组化法检测标本的PR状况 ,并随访。　结果　 12 8例NL乳腺癌患者随访 12 6例 ,占 98 4% ,随访时间 90 0～ 174 0个月 ,平均110 9个月。 12 8例NL乳腺癌PR检测阳性 6 8例 ,阳性率为 5 3 1% ,同期 2 6 6例PL乳腺癌PR阳性 83例 ,阳性率为 31 2 % ,二者的差异有非常显著性意义 (χ2 =17 5 7,P <0 0 1)。NL乳腺癌发生转移和复发 2 4例 ,PR阳性和阴性组的复发率分别为 10 3%和 2 8 3% ,二者的差异有显著性意义 (χ2 =5 2 4,P<0 0 5 ) ;5年生存率分别为 95 5 %和 88 1% (χ2 =2 34 ,P >0 0 5 ) ;10年生存率分别为 80 0 %和 6 5 5 %(χ2 =1 40 ,P >0 0 5 ) ;7年病死率分别为 4 4%和 16 7% (χ2 =5 2 4,P <0 0 5 ) ,二者差异有显著性意义。　结论　NL乳腺癌的PR是影响预后的重要因素 ,PR阴性组乳腺癌复发转移明显高于PR阳性组 ,且易转移至内脏 ,其 7年病死率明显高于PR阳性组 ,5年和 10年生存率也低于PR阳性组。故对NL乳腺癌 ,当PR阴性时 ,应积极施行包括化疗在内的辅助治疗以提高疗效。Objective To study the effect o f progesterone receptor (PR) status on the prognosis of breast cancer with negat ive axillary lymph nodes (NL). Methods PR stat us was immunohistochemically examined in the specimens of 128 NL and 266 breast cancer patients with positive axillary lymph nodes (PL) who were operated on fr om April 1985 to August 1992, and followed up. Results[WT5 ”BZ] 126 of 128 NL breast cancer patients (98 4%) were followed up from 90 to 174 months, with 110 9 months on average. The positive rate of PR in NL bre ast cancer (53 1%) was significantly higher than that of PL breast cancer (31 2%) (χ 2=17 57, P <0 01). A totall of 24 cases suffered from relapse or metastasis, the recurrent rate of PR(+) group (10 3%) was significantly lower than that of PR(-) group (28 3%) (χ 2=5 80, P <0 05). In PR (+) and PR (-) group, the 5 year survial rates were 95 5% and 88 1% (χ 2=2 34, P >0 05), the 10 year survival rates 80 0% and 65 5% (χ 2=1 40, P >0 05), and the 7 year death rates were 4 4% and 16 7% respectively (χ 2=5 24, P <0 05). Conclusion PR in NL breast cancer is an important prognostic factor, the recurrent rate as well as the 7 y ear death rate in the PR (-) group is significantly higher than that of the PR (+) group. If easily metastatizes to visceral organs, and the 5 year and 10 y ear survival rates of the PR (-) group are also lower than those of PR (+) group . As to NL breast cancer patients, when PR is negative, we should actively make any auxiliary treatment apart from chemotherapy to increase their therapeutic ef fect.

关 键 词：乳腺肿瘤 腋淋巴结 孕酮受体 预后 PR 

分 类 号：R737.9[医药卫生—肿瘤]