Ki67、PgR在ER阳性且HER-2阴性乳腺癌Luminal分型中的意义  

The significance of Ki67 and PgR in distinguishing ER-positive and HER-2-negative Luminal breast cancers

作　　者：胡越[1] 贾卫娟[1] 谭翠[1] 顾然[1] 杨雅平[1] 刘凤桃 苏逢锡[1] 

机构地区：[1]中山大学孙逸仙纪念医院乳腺肿瘤医学部,广州510120

出　　处：《岭南现代临床外科》2016年第2期123-126,共4页Lingnan Modern Clinics in Surgery

基　　金：国家自然科学基金(81372817)

摘　　要：目的探讨Ki67、Pg R在Luminal型乳腺癌分型中的意义。方法回顾中山大学孙逸仙纪念医院2006~2012年入院治疗的ER阳性且HER-2阴性浸润性乳腺癌病人,收集病人的基本临床病理资料和随访结果。以无病生存时间为研究终点,采用Kaplan-Meier检验和Cox回归进行生存分析。结果共964例浸润性乳腺癌入组。K-M单因素分析结果表明,Ki67 14%具有统计学意义,而Pg R 20%仅在早期生存分析时具有统计学意义。Cox多因素分析结果表明,Ki67是无病生存的独立预测因子,而Pg R却没有统计学意义。Ki67低表达且Pg R低表达的亚组较Ki67高表达且Pg R高表达的亚组有着不一致的生存结果。结论在ER阳性且HER-2阴性乳腺癌Luminal分型中,不能将Pg R和Ki67置于同等重要的位置,对于Ki67低表达且Pg R低表达的乳腺癌,需要结合其它临床病理资料或多基因分析。Objective The objective of this study was to analyze the prognostic significance of Ki67 and Pg R in distinguishing Luminal breast cancers. Methods Patients with ER-positive and HER-2-negative invasive breast cancer who were treated from 2006 to 2012, were selected by searching breast cancer registries at Sun Yat-sen Memorial Hospital..Clinicopathologic characteristics and prognoses were collected. The primary end point was DFS（disease free survival） which was analyzed by Kaplan-Meier curve with log rank test or Breslow test. Cox proportional hazards model was used to balance the risk factors for prognosis. Results A total of 964 patients with invasive breast cancer were eligible for inclusion in this study. Ki67 was found to be of prognostic significance in univariate analysis and multivariate analysis, but Pg R was not an independent risk factor. Patients with lowKi67-level and low-Pg R level had different prognoses with high-Ki67-level and high-Pg R-level subtype. Conclusion In order to optimize management of ER-positive and HER-2-negative patients,we need to consult other clinicopathologic characteristics or multi-gene assay, especially for low-Ki67-level and low-Pg R level subtype.

关 键 词：KI67 PgR 乳腺癌 LUMINAL A LUMINAL B 无病生存 

分 类 号：R737.9[医药卫生—肿瘤]