大连市不同型别乳腺癌患者的临床病理特征与生存状况研究  

Clinical investigation of clinicopathological characteristics and survival status of female patients with different types of breast cancer in Da lian City

作　　者：李传书[1] 葛述科[1] 高伟[1] 孙嘉忆[1] 陈波[2] Li Chuanshu;Ge Shuke;Gao Wei;Sun Jiayi;Chen Bo(Dalian Central Hospital,Dalian,Liaoning 116033,China;Department of Gastroenterology,the First Affiliated Hospital of China Medical University,Liaoning 110001,China)

机构地区：[1]辽宁省大连市中心医院,116033 [2]中国医科大学附属第一医院消化内科,沈阳110001

出　　处：《中华普外科手术学杂志（电子版）》2020年第3期268-272,共5页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：辽宁省科技厅科学技术计划项目(2013225049)。

摘　　要：目的分析大连市不同型别乳腺癌妇女的临床病理特征与生存状况。方法选取2014年10月至2016年10月期间行外科手术的226例原发单侧乳腺癌患者为研究对象,根据分子分型分为Luminal A型、Luminal B型、HER-2型、三阴型,比较四种分型的临床病理资料和随访结果并比较之。采用SPSS19.0统计学软件进行数据处理。观测资料主要为计数资料,以例数及率描述,单因素分析采用χ^2检验。生存资料建立Kaplan-Meier乘积限模型,生存率比较应用Logrank检验。以P<0.05视为有统计学意义。结果LuminalA型、Luminal B型、HER-2型、三阴型分别占28.8%、34.1%、14.6%、22.6%。不同分子分型患者的肿瘤最大径、淋巴结转移、组织学分级、术后内分泌治疗等比较,差异有统计学意义(P<0.05)。四组不同分子分型患者的3年无病生存率、总生存率(OS)比较,经Logrank检验,仅Luminal A型的PFS生存率明显高于三阴型(P<0.05),其他差异无统计学意义(P>0.05)。结论大连市乳腺癌妇女患者以Luminal B型最常见,LuminalA型组织学分级较低,预后较好;HER-2型肿瘤较大,但淋巴结转移率较低;三阴型容易发生淋巴结转移,预后较差。内分泌治疗对Luminal型效果较好,靶向药物化疗适用于HER-2型和三阴型患者,放疗适用于晚期乳腺癌患者,尤其是三阴型。Objective To analysis the clinicopathological characteristics and survival status of female patients with different types of breast cancer in Da lian City.Methods A retrospective analysis was performed in 226 patients with primary unilateral breast cancer,who underwent surgery from October 2014 to October 2016.According to the molecular classification,they were divided into four types,including Luminal A,Luminal B,HER-2,and Triple negative.The clinicopathological data and follow-up results of patients with different types were analyzed.Statistical analysis were performed by using SPSS19.0 software.The observational data were mainly count data,and were described as cases and rate,and were examined by using the single factor analysis ofχ^2 test.Survival data were analyzed by using Kaplan-Meier method.Logrank test was used to compare survival rates.A value of P<0.05 was considered as statistically significant difference.Results Luminal A type,Luminal B type,HER-2 type,and triple negative ty pe accounted for 28.8%,34.1%,14.6%,and 22.6%,respectively.There were significant differences among patients with different molecular types,in terms of tumor size,lymph node metastasis,histological grade,and postoperative endocrine therapy(P<0.05).Three-year progression-free survival(PFS),overall survival(OS)were compared among four groups of patients with different molecular types.Logrank test showed that the PFS in Luminal A group was significantly higher than that in triple negative group(P<0.05),however there no significant differences between other groups(P>0.05).Conclusions Luminal B is the most common type of breast cancer in female patients in Dalian city.There are lower histological grade and better prognosis in Luminal A type.There are larger tumors and lower rate of lymph node metastasis in HER-2 type.Triple negative type is prone to lymph node metastases,and the prognosis is poor.Endocrine therapy has a better effect on Luminal type,targeted drug chemotherapy is suitable for HER-2 or Triple negative type patients,and

关 键 词：乳腺肿瘤 分子分型 病理学 临床 生活质量 

分 类 号：R73[医药卫生—肿瘤]