不同分子亚型乳腺浸润性小叶癌的临床特征及其预后  

Clinicopathological characteristics and prognosis of patients with breast invasive lobular carcinoma by different molecular subtypes

作　　者：彭菲[1] 姬瑶 杨艳芳[1] 吴超[1] 徐文婷[1] 刘君[1] PENG Fei JI Yao YANG Yanfang WU Chao XU Wenting LIU Jun(Second Department of Breast Cancer of Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Breast Cancer Prevention and Therapy （Ministry of Education）, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China The Breast and Thyroid Department of Fourth Division Hospital of Xinjiang Production and Construction Corps, Yili Prefecture B35000, Xinjiang Uygur Autonomous region, China)

机构地区：[1]天津医科大学肿瘤医院乳腺二科,国家肿瘤临床医学研究中心,乳腺癌防治教育部重点实验室,天津市肿瘤防治重点实验室,天津300060 [2]新疆兵团四师医院乳甲科,新疆维吾尔自治区伊犁州835000

出　　处：《肿瘤》2016年第12期1369-1375,共7页Tumor

摘　　要：目的 :探讨不同分子亚型乳腺浸润性小叶癌(invasive lobular carcinoma,ILC)患者的临床病理特征及预后相关因素。方法 :收集天津医科大学肿瘤医院2003年1月1日—2012年12月31日收治的381例乳腺ILC患者的临床病理资料,基于免疫组织化学检测结果进行分子分型[Luminal A型、Luminal B型、人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)过表达型和三阴型],比较不同分子亚型乳腺ILC患者的临床病理特征及预后差异,以及影响预后的相关因素。结果 :不同分子亚型乳腺ILC所占比例存在显著差异,其中以Luminal B型所占比例最高(66.4%),其余依次为Luminal A型、三阴型和HER2过表达型(分别为16.8%、11.3%和5.5%)。不同分子亚型乳腺ILC患者的发病年龄、绝经状态和腋窝淋巴结转移状态存在显著差异(P值均<0.05)。单因素分析结果显示,肿瘤大小、腋窝淋巴结转移状态、临床分期、分子亚型、手术方式、术后放疗和内分泌治疗均与乳腺ILC患者的预后相关(P值均<0.05)。Luminal A型的5年总生存率为100.0%,Luminal B型为91.2%,明显高于HER2过表达型(55.6%)和三阴型(50.9%)。多因素分析结果显示,肿瘤大小、分子亚型、腋窝淋巴结转移状态以及内分泌治疗均是乳腺ILC患者预后的独立影响因素(P值均<0.05)。结论 :乳腺ILC分子亚型对于预测其预后具有重要的意义,需要进一步研究以指导临床上ILC患者的精准化个体治疗。Objective： To investigate the clinical features and the relationship between molecular subtypes and the clinical features and prognosis of invasive Iobular carcinoma （ILC） of breast. Methods： The clinical records of 381 patients with resectable breast ILC in Tianjin Medical University Cancer Institute and Hospital were collected from January 1, 2003 to December 31, 2012. Based on the result of immunohistochemistry, four molecular subtypes were determined, including Luminal A, Luminal B, human epidermal growth factor receptor 2 （HER2） over-expression and triple-negative breast cancer （TNBC）. The correlations of the prognosis in patients with different breast cancer molecular subtypes and the clinicopathological characteristics were analyzed. Results： The proportions of the four molecular subtypes were different; Luminal B accounted for the highest proportion （66.4%） and the proportions of Luminal A, HER2 over-expression and TNBC were 16.8%, 5.5% and 11.3%, respectively. There were statistical differences among different molecular subtypes of breast ILC regarding the age, menopausal status and lymph node metastasis （all P 〈 0.05）. The univariate analysis showed that factors affecting the prognosis of breast ILC were tumor size, axillary lymph node metastasis, clinical stage, molecular subtypes, surgical method, post-operative radiotherapy and endocrine therapy （all P 〈 0.05）. The 5-year overall survival rates of patients with Luminal A and Luminal B subtypes were 100.0% and 91.2%, respectively, which were significantly higher than those of the HER2 over-expression and TNBC subtypes （55.6% and 50.9%, respectively）. Multivariate analysis found that the tumor size, molecular subtypes, axillary lymph node metastasis and endocrine therapy were the independent prognostic factors of breast ILC （all P 〈 0.05）. Conclusion： Molecular subtype classification has great significance in predicting the prognosis of breast ILC. Further studies are needed to guide the individual treatmen

关 键 词：乳腺肿瘤 浸润性小叶癌 分子亚型 临床特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]