乳腺癌分子分型对保乳边缘状态及预后的影响  

Breastcancermolecular subtypesareassociated with margin status and prognosis after early stage breast⁃conservingsurgery

作　　者：贾海霞[1] 贾卫娟[2] 夏婷[1] 胡小戊[1] 曹腾飞[1] 陈欣欣[1] 章乐虹[1] 钟玲[1] JIA Haixia;JIA Weijuan;XIA Ting;HU Xiaowu;CAO Tengfei;CHEN Xinxin;ZHANG Lehong;ZHONG Ling(The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;不详)

机构地区：[1]广州医科大学附属第二医院,广州510260 [2]中山大学孙逸仙纪念医院,广州510260

出　　处：《实用医学杂志》2021年第10期1288-1292,共5页The Journal of Practical Medicine

基　　金：广东省自然科学基金(博士启动)(编号:2017A030310366)。

摘　　要：目的探讨乳腺癌分子分型对保乳边缘状态以及预后的影响。方法对1032例拟保乳乳腺癌患者的临床病理资料进行回顾性分析,利用单变量及多变量分析分子分型、年龄及肿瘤大小等临床病理特征与阳性手术边缘以及预后的相关性。结果20.3%(209/1032)患者边缘阳性。多变量分析显示Her⁃2+型乳腺癌、EIC及阳性淋巴结与阳性边缘具有统计学相关性(P<0.01);利用Kaplan⁃Meier生存曲线,不同分子分型的预后,在DFS,LRRFS和DMFS差异有统计学意义(P<0.05)。结论Her⁃2+乳腺癌是保乳阳性边缘的独立影响因素;Luminal⁃HER⁃2分型和HER⁃2+分型是保乳患者预后差的独立预后因素。Objective To investigate the effect of molecular subtype on the margin statusof breast⁃conserving surgery(BCS)and prognosis.Methods We retrospectively reviewed the clinical and histopathologic data of 1032 consecutive womenat the time of diagnosis with breast cancer deemed suitable for BCS treated with lumpectomy.Univariate and multivariate analyses were used to determine the relationship between the molecular subtype,age,tumor size and positive surgical margins and prognosis.Results 20.3%of the(209/1032)patients had evidence of cancer intheir cavity margins(CM).By multivariate analysis,the HER⁃2 BC subtype,EIC,pN stage were sig⁃nificantly correlated with positive CMs(P<0.01).Kaplan⁃Meier survivalanalysis revealed statistically significant differencesin DFS,LRRFS,and DMFS,among the breast cancer subtypes(P<0.05).Conclusion The HER⁃2 positive subtype is the predictive factor that is most associated with positive CMs.The luminal⁃HER⁃2 and HER⁃2 subtypesareindependent prognostic factors for worse outcomes in patients with breast⁃conserving surgery.

关 键 词：乳腺癌 保乳手术 分子分型 边缘 

分 类 号：R61[医药卫生—外科学]