分子分型对乳腺导管内原位癌无复发生存率的影响  

Effect of tumor subtype on recurrent-free survival in patients with ductal carcinoma in situ of the breast

作　　者：谢惠君 李洪梅 吴柳华[1] 陈建安[1] 陈勇[1] 王晓华[1] XIE Huijun;LI Hongmei;WU Liuhua;CHEN Jian'an;CHEN Yong;WANG Xiaohua(Department of General Surgery, Xiaolan People's Hospital of Zhongshan, Zhongshan 528415, China)

机构地区：[1]中山市小榄人民医院(南方医科大学附属小榄医院)普外科,广东中山528415

出　　处：《中国肿瘤外科杂志》2020年第2期126-129,共4页Chinese Journal of Surgical Oncology

基　　金：广东省中山市科技计划医疗卫生类科研项目(2015A020322)。

摘　　要：目的探讨乳腺导管内原位癌(DCIS)的分子分型与无复发生存率的关系。方法选取南方医科大学附属小榄医院普外科2008年1月至2016年6月收治的DCIS患者135例,根据分子分型分为四个亚组[性激素受体(HR)+/人类表皮生长因子受体2(HER2)-组83例,HR+/HER2+组26例,HR-/HER2+组16例,三阴型(TN)组10例],比较四组患者的病理分级、肿瘤大小、放疗等临床病理资料及生存预后情况;随访48个月,采用Cox回归分析患者预后的影响因素。结果四组的病理分级和生存状态差异有统计学意义,TN组多为低分化或未分化,未见高分化,且肿瘤复发比例较高(P<0.05)。四组在生存时间、年龄、肿瘤部位、肿瘤大小、手术方式、有无放疗方面差异无统计学意义;HR+/HER2-组无复发生存率为92.7%,HR+/HER2+组为92.3%,HR-/HER2+组为87.5%,TN组为70.0%。Cox回归分析结果显示TN亚型是无复发生存率的危险因素(aHR=3.538,P=0.005),而放疗是无复发生存率的保护因素(aHR=0.325,P=0.005)。结论分子分型是影响DCIS患者预后的独立危险因素之一,TN型DCIS患者预后较其他亚型差,放疗能改善DCIS患者的无复发生存率。Objective To evaluate the recurrent-free survival of patients with ductal carcinoma in situ of the breast(DCIS)with special emphasis on the role of the tumor subtype.Methods The data obtained from the Department of General Surgery of Xiaolan People's Hospital from 2008 to 2016 were retrospectively analyzed.Cohort study was conducted to investigate tumor subtype-specific differences in various characteristics and recurrent-free survival(RFS).Results 135 patients with DCIS were eligible during the study period.Compared with the other subgroups,patients with triple negative(TN)breast cancer were more likely to have tumors with low grade and high recurrence rate.There was no significant difference in survival time,age,tumor location,tumor size,surgical method and radiotherapy between the four groups.The recurrence-free survival rate was 92.7%in HR+/HER2-group,92.3%in HR+/HER2+group,87.5%in HR-/HER2+group and 70.0%in TN group.Cox regression analysis showed that TN subtype was a risk factor for relapse free survival(aHR=3.538,P=0.005),while radiotherapy was a protective factor for relapse free survival(aHR=0.325,P=0.005).Conclusions The results demonstrate that DCIS appears to alter the prognosis associated with the TN subtype.

关 键 词：乳腺导管原位癌 无复发生存率 分子分型 受体 表皮生长因子 性激素受体 

分 类 号：R73[医药卫生—肿瘤]