乳腺癌腋窝淋巴结转移的危险因素  

Risk factors for axillary lymph node metastasis in breast cancer

作　　者：钟鸣[1] 刘英霞[1] 翁剑华[2] 黄卓雅[3] 

机构地区：[1]广东省惠州市第一人民医院病理科,广东惠州516003 [2]广东省惠州市第一人民医院乳腺外科,广东惠州516003 [3]广东省惠州市中心人民医院病理科,广东惠州516001

出　　处：《热带医学杂志》2018年第1期43-46,F0003,共5页Journal of Tropical Medicine

基　　金：惠州市科技局计划项目(2016Y061)

摘　　要：目的探讨多个分子标记物、临床病理特征(年龄、临床分期、组织学分级)和分子亚型是否为乳腺癌腋窝淋巴结(ALN)转移的危险因素。方法通过免疫组化方法和荧光原位杂交(FISH)观察198名原发乳腺癌患者雌激素受体(ER)、孕激素受体(PR)、原癌基因人类表皮生长因子(HER2)、雄激素受体(AR)、B淋巴细胞瘤-2基因(Bcl-2)、表皮生长因子受体(EGFR)的表达情况,并根据ER,PR,HER2这三个指标的表达将研究对象分为不同分子亚型,最后通过统计学分析筛选能预测腋窝淋巴结转移的危险因素。结果肿瘤大小、病理组织学分级和多个分子学标记物在单变量二元Logistic回归分析中均是ALN发生转移的重要指标,但仅有肿瘤大小、Bcl-2、EGFR、HER2是ALN发生转移的独立预测因子。与Luminal A型相比,HER2过表达、Luminal B型和三阴乳腺癌转移的风险分别增加6.87,6.32和3.58倍。结论肿物大小,Bcl-2,EGFR,HER2的表达是乳腺癌腋窝淋巴结转移重要的危险因素。Objective To investigate whether the multiple molecular markers,clinicopathological features（age,clinical stage,histological grade）and molecular subtypes were the risk factors for breast cancer axillary lymph nodes（ALN）metasta-sis. Methods The expression of estrogen receptor（ER）,progesterone receptor（PR）,Her2,AR,B-cell lymphoma-2（Bcl-2） and epidermal growth factor receptor（EGFR）in 198 patients with primary breast cancer was observed by immunohistochemis-try and they were classified into four molecular subtypes groups according to the expression of ER,PR and Her2. Whether these risk factors could predict axillary lymph node metastasis was evaluated by statistical analysis and other clinical and patho-logical parameters. Results Although tumor size,histological grade,and multiple molecular markers were important markers of ALN metastasis in univariate binary logistic regression analysis,only tumor size,Bcl-2,EGFR,and HER2 were the most frequently involved in ALN involvement independent predictors of variable analysis. Compared with Luminnal A,the risk of HER2 overexpression,Luminal B and triple-negative breast cancer metastasis were increased by 6.87,6.32 and 3.58 times,respectively. Conclusion The expression of Bcl-2,EGFR and HER2 were significantly correlated with the metastasis of breast cancer cells,and they could be the powerful indicators of metastasis of axillary lymph node in breast cancer.

关 键 词：乳腺癌 腋窝淋巴结转移 分子亚型 BCL-2 EGFR HER2 

分 类 号：R737.9[医药卫生—肿瘤]