30岁及以下乳腺癌术后首次复发转移特点分析  

Analysis of the first recurrent pattern after radical surgery in breast cancer aged 30 years and younger

作　　者：王秋明[1] 李亮[1] 张锦丰[1] 吴静娜[1] WANG Qiuming;LI Liang;ZHANG Jinfeng;WU Jingna(Department of Chemotherapy,Meizhou People s Hospital,Meizhou 514031,China)

机构地区：[1]梅州市人民医院化疗科

出　　处：《广州医药》2020年第1期50-54,65,共6页Guangzhou Medical Journal

基　　金：梅州市医药卫生项目(编号:2016-B-33)

摘　　要：目的探讨分析30岁及以下青年乳腺癌患者术后首次复发转移特点,以期指导术后随访,早期发现转移病灶。方法回顾性分析2003年1月—2018年8月在梅州市人民医院收治的年龄≤30岁乳腺癌患者73例,所有患者均行根治性手术治疗,分析临床病理特点及术后首次复发转移特点。结果共纳入23例三阴性(31.5%)、20例luminal B(HER2-)型(27.4%)、12例HER-2阳性型(16.4%)、10例Luminal B(HER2+)型(13.7%)、4例Luminal A型(5.5%)和4例分型不明(5.5%)。中位随访28.4个月,7例三阴性(7/23,30.4%)、6例HER-2阳性型(6/12,50.0%)、4例Luminal B(HER2-)型(4/20,20.0%)和3例Luminal B(HER2+)型(3/10,30.0%)出现复发转移。复发转移患者中,90.0%合并远处转移,75.0%合并内脏转移,其中HER-2阳性型均合并内脏转移;92.3%(12/13)激素受体阴性患者复发转移发生在术后2年内。三阴性患者最常见远处转移部位是远处淋巴结,HER-2阳性型患者最常见远处转移部位是肝,luminal B(HER2+)型患者最常见远处转移部位是肺和骨,luminal B(HER2-)型患者最常见远处转移部位是肺和远处淋巴结。结论≤30岁青年乳腺癌患者术后首次复发转移多合并远处转移,激素受体阴性患者容易早期复发,不同分子分型患者具有不同的好发远处转移部位。Objective We retrospectively investigated the first recurrent pattern after radical surgery in breast cancer patients aged≤30 years,so as to guide postoperative follow-up and early detection of recurrent lesions.Methods A total of 73 consecutive early breast cancer patients aged≤30years admitted to Meizhou People s Hospital from January 2003 to August 2018 were included.Retrospective analysis was conducted to analyze the clinicpathologic characteristics and characteristics of first recurrent pattern.Results 23 triple negative(31.5%),20 Luminal B(27.4%),12 HER2 enriched(16.4%),10 Luminal/HER2+(13.7%),4 Luminal A(5.5%)and 4 undifined subtypes(5.5%)were included.After a median follow-up of 28.4 months,20 patients relapsed,which included 7 triple-negative(7/23,30.4%),6 HER2-enriched(6/12,50.0%),4 luminal B(4/20,20.0%)and 3 luminal/HER2+(3/10,30.0%)subtypes.90.0%of patients combined with distant metastasis.75.0%of patients had visceral metastasis,which included all the recurrent HER-2 enriched patients.92.3%of hormone receptor negative(HR-)patients had a RFS less than 2 years.The most common metastatic sites in triple-negative,HER-2-enriched,luminal/HER2+and luminal B subtypes were distant nodes,liver,lung and bone,distant nodes and lung,respectively.Conclusion The first recurrent pattern mainly presented as distant metastasis in breast cancer patients aged≤30 years,with early relapse in patients with HR-diseases.Different molecular subtypes of breast cancer favor different distant metastatic sites.

关 键 词：青年 乳腺恶性肿瘤 肿瘤转移 

分 类 号：R737.9[医药卫生—肿瘤]