Lumina型乳腺癌患者21基因复发风险评分与临床病理特征的相关性及其临床意义  

Correlation between 21-gene recurrence score and clinicopathological characteristics of patients with Lumina type breast cancer and its clinical significance

作　　者：连婧[1] 郗彦凤[1] 高宁[1] 马海霞[1] 薛登峰[2] 王丽霞[1] Lian Jing;Xi Yanfeng;Gao Ning;Ma Haixia;Xue Dengfeng;Wang Lixia(Department of Pathology,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China;Department of Breast Surgery,Shanxi Provincial Cancer Hospital,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院病理科,太原030013 [2]山西省肿瘤医院乳腺外科,太原030013

出　　处：《肿瘤研究与临床》2021年第3期195-199,共5页Cancer Research and Clinic

基　　金：山西省肿瘤医院院所基金(0200198)。

摘　　要：目的分析Lumina型乳腺癌患者21基因复发风险评分(RS)与临床病理特征的相关性,探讨其在个体化治疗中的意义。方法回顾性分析2018年5月至2019年5月山西省肿瘤医院收治的59例手术切除并经病理确诊的Lumina型乳腺癌患者的临床病理资料。采用实时荧光定量聚合酶链反应检测21基因的表达并计算RS。根据21基因RS结果分为低复发风险组(RS<18分)、中复发风险组(RS 18~31分)、高复发风险组(RS>31分)。采用单因素和多因素logistic回归分析评估不同复发风险与患者临床病理特征的相关性及对辅助化疗选择的影响。结果根据21基因RS,低复发风险组29例,中复发风险组22例和高复发风险组8例。单因素分析结果显示,年龄(P=0.012)、肿块最大径(P=0.031)、组织学分级(P=0.036)、孕激素受体(PR)水平(P=0.015)、Ki-67阳性指数(P=0.049)及分子分型(P=0.010)均是21基因RS复发风险的影响因素。多因素logistic回归分析显示,年龄、Ki-67阳性指数与21基因RS复发风险负相关(均P<0.05)。根据21基因RS分组后,依据乳腺癌传统术后复发风险分组的17例中复发风险组患者归类为低复发风险组,4例低复发风险组患者归类为中复发风险组(χ^(2)=4.535,P=0.033)。根据21基因RS分组后,个体化治疗中需要接受化疗的患者减少。17例中有11例未行术后化疗,其余患者均进行了化疗,术后随访11~22个月,截至2020年3月均未见复发或疾病进展。结论21基因RS可为早期Lumina型乳腺癌患者的个体化精准治疗及预后预测提供客观依据。Objective To analyze the correlation between 21-gene recurrence score(RS)and clinicopathological characteristics of patients with Lumina type breast cancer,and to explore its significance in individualized treatment.Methods The clinicopathological data of 59 patients with surgical resection and pathological diagnosis of Lumina type breast cancer in Shanxi Provincial Cancer Hospital from May 2018 to May 2019 were retrospectively analyzed.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of 21 gene and RS was calculated.According to the 21-gene RS,the patients were divided into low recurrence risk group(RS<18 points),intermediate recurrence risk group(RS 18-31 points)and high recurrence risk group(RS>31 points).Univariate and multivariate logistic regression analyses were made to evaluate the correlations between different recurrence risk and clinicopathological characteristics of patients and their influence on the choice of adjuvant chemotherapy.Results Based on the 21-gene RS,29 patients were in low recurrence risk group,22 cases were in intermediate recurrence risk group,and 8 cases were in high recurrence risk group.Single-factor analysis showed that age(P=0.012),maximum mass diameter(P=0.031),histological grade(P=0.036),progesterone receptor(PR)level(P=0.015),Ki-67 positive index(P=0.049)and molecular typing(P=0.010)were influencing factors of 21-gene RS recurrence risk.Multivariate logistic regression analysis showed that the age and Ki-67 positive index were negatively correlated with 21-gene RS recurrence risk(both P<0.05).After grouping according to the 21-gene RS,17 patients in the intermediate recurrence risk group(according to the traditional postoperative recurrence risk grouping method for breast cancer)were classified as low recurrence risk group,and 4 patients in the low recurrence risk group were classified as intermediate recurrence risk group(χ^(2)=4.535,P=0.033).After grouping based on 21-gene RS,the number of patients who needed chemotherapy in in

关 键 词：乳腺肿瘤 分子分型 21基因 复发 

分 类 号：R737.9[医药卫生—肿瘤]