乳腺黏液癌21基因复发风险评分与临床病理关系  

21-gene recurrence score and clinicopathological characteristics in patients with mucinous breast cancer

作　　者：吴佳毅[1] 靳疆 陈伟国[1] 丁淑宁 林琳[1] 费晓春[1] 洪进[1] 高卫奇[1] 朱思吉[1] 宗瑜[1] 陈小松[1] 黄欧[1] 何建蓉[1] 朱丽[1] 李亚芬[1] 沈坤炜[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科乳腺疾病诊治中心,上海200025 [2]新疆伊犁州妇幼保健院乳腺外科,新疆伊犁835000

出　　处：《外科理论与实践》2017年第5期397-400,共4页Journal of Surgery Concepts & Practice

基　　金：上海市市级医院新兴前沿技术联合攻关项目(SHDC12014103);上海市科学技术委员会医学引导类基金(15411966400);上海市科学技术委员会科技创新行动计划(14411950200;14411950201)

摘　　要：目的:分析21基因复发风险评分(recurrence score,RS)在乳腺黏液癌的表达及其影响因素。方法:回顾性分析2013年1月至2017年6月95例雌激素受体阳性、人表皮生长因子受体2阴性及淋巴结阴性乳腺癌病人,对石蜡标本使用逆转录-聚合酶链反应进行21基因检测并计算RS。使用确切概率法比较不同RS与临床病理特征的关系,使用Logistic回归分析RS危险度分级的独立影响因素。结果:95例病人中位RS为21(3~59)分,低危、中危及高危复发风险病人各30例(31.6%)、49例(51.6%)及16例(16.8%)。RS在不同Ki67表达(P=0.024)及分子分型(P=0.013)病人中存在显著差异。多因素分析显示,分子分型是RS危险度分级的独立影响因素,Luminal B-like亚型病人RS为中危或高危的可能性显著增加(中危比低危:OR=3.390,95%CI:1.195~9.615,P=0.022;高危比低危:OR=4.425,95%CI:1.076~18.182,P=0.039)。结论 :乳腺黏液癌RS与Ki67表达及分子分型相关。分子分型是RS危险度分级的独立影响因素。Objective To explore the clinical significance of 21-gene recurrence score（RS） in the patients with mucinous breast cancer. Methods Ninety-five patients with mucinous breast cancer who had no involved lymph node and ER positive and HER2 negative from January 2013 to June 2017 were retrospectively recruited. Reverse transcriptasepolymerase chain reaction of 21-genes were conducted in paraffin-embedded tumor tissue and RS was calculated. Correlations between RS and clinicopathologic factors were evaluated using Fisher′s exact test. Logistic regression was used to determine independent predictive factors of RS. Results The median RS of 95 patients was 21（range： 3-59） and the patients were categorized as low, intermediate and high risk 31.6%, 51.6% and 16.8%, respectively. The difference of RS was found significantly when Ki67 index（P=0.024） and molecular subtypes（P=0.013） varied. Molecular subtype was an independent predictive factor of RS. Luminal B-like subtype was associated with higher RS（intermediate risk vs. low risk：OR =3.390, 95% CI： 1.195-9.615, P =0.022; high risk vs. low risk： OR =4.425, 95% CI： 1.076-18.182 P =0.039）. Conclusions RS of the patients with mucinous breast cancer related with Ki67 index and molecular subtypes. Molecular subtype could predict RS as low, intermediate or high risk independently.

关 键 词：乳腺黏液癌 21基因 复发风险评分 分子分型 

分 类 号：R737.9[医药卫生—肿瘤]