间隔时间与内分泌治疗对双侧原发乳腺癌生物学指标及预后的影响  

Effectsof the time interval and the endocrine therapy on the prognosis and consistency of the biological indicatorsin patients with bilateral primary breast cancer

作　　者：王昊天[1] 段晶晶[1] 侯辛未 叶贝贝 曹旭晨[1] 

机构地区：[1]天津医科大学肿瘤医院、国家肿瘤临床医学研究中心、天津市“肿瘤防治”重点实验室、乳腺癌防治教育部重点实验室,300060

出　　处：《中华医学杂志》2016年第4期281-284,共4页National Medical Journal of China

摘　　要：目的探讨双侧原发性乳腺癌（BPBC）两癌发生的间隔时间，以及第一原发癌手术后是否接受内分泌治疗对于两癌间生物学指标一致性及预后的影响。方法回顾性分析天津医科大学附属肿瘤医院2005年1月至2008年12月收治的133例BPBC患者的病例资料，根据不同发病间隔时间和内分泌治疗情况分4组（≤6个月、6～≤24个月、24～≤60个月及〉60个月组），侧重分析不同分组中两癌间雌激素受体（ER）、孕激素受体（PR）以及人表皮生长因子受体2（HER-2）表达的一致性以及间隔时间与内分泌治疗情况对于患者预后的影响。结果随着时间间隔的延长，两癌间生物学指标的一致率呈现下降趋势，每一组中ER（71．7％、70．6％、44．4％、52．8％）一致率均高于PR（69．8％、64．7％、37．0％、47．2％），间隔时间≤6个月组中ER（71．7％）、HER-2（86．8％）在两癌间具有良好一致性和相关性（P≤0．05）。第一原发癌手术后未接受内分泌治疗的患者两癌间生物学指标一致率更高（ER：65．1％与57．1％；PR：57．1％与55．7％），该组中ER在两癌间具有良好一致性和相关性（P≤0．05）。时间间隔和内分泌治疗情况均未对患者总生存产生明显影响。结论BPBC两癌间生物学指标的一致性随着间隔时间的延长而下降，6个月之内发生的BPBC患者两癌间ER、HER．2有很高相似性。内分泌治疗会影响第二原发癌与第一原发癌生物学指标的一致性，但均不会影响患者的预后。Objective The study aimed to discuss whether the time interval between bilateral primary breast cancers （BPBC） and the endocrine therapy status after thefirst primary cancer could influence the prognosis and consistency of the biological indicators. Methods Clinical data of 133 patients with BPBC in cancer institute and hospital of Tianjin medical university from January 2005 to December 2008 were retrospectively analyzed. The patients were divided into two groups according to the time interval and the endocrine therapy. The consistency of hormone receptor and human epidermal growth factor receptor-2 （HER-2） expression between the bilateral tumors and the prognosis of BPBC in different groups were analyzed. Results With the extension of time interval, the consistent rate of biological indicators between the bilateral tumorshas decreased. The consistent rate of estrogen receptor （ER） was higher than that of progestin hormone （PR） in each group. When the time interval was six or less months, ER and HER-2 had the consistency and correlation between the two primary cancers （P ≤ 0. 05 ）. In patients who did not receiveendocrine therapyafter the first cancer, the consistent rates of the biological indicators were higher and ER had betterconsistency and correlation （P ≤0. 05 ）. Time interval and endocrine therapy hadno effecton the overall survival of the patients. Conclusion With the extension of the time interval, the consistency of the biological indicators in BPBChas decreased. ER and HER-2 of the bilateral tumorshad a high similarity in patients whose time interval wasno more than 6 months. Endocrine therapy could also affect the consistency of the biological indicators. However, these two factors were not associated with prognosis in patients with BPBC.

关 键 词：乳腺肿瘤 间隔时间 内分泌治疗 生物学指标 预后 

分 类 号：R737.9[医药卫生—肿瘤]