广西地区不同分子分型乳腺癌的临床病理特征及预后研究  

Clinicopathological characteristics and prognosis of breast cancer with different molecular subtypes in Guangxi

作　　者：练斌[1] 洪朝寅 余锦婕 叶成林 王晓婷[2] 蒙伟宇 邱海潮 覃庆洪[1] 韦长元[1] LIAN Bin;HONG Chaoyin;YU Jinjie;YE Chenglin;WANG Xiaoting;MENG Weiyu;QIU Haichao;QIN Qinghong;WEI Changyuan(Department of Breast Surgery,Affiliated Cancer Hospital of Guangxi Medical University,Nanning 530021,China;不详)

机构地区：[1]广西医科大学附属肿瘤医院乳腺外科,南宁530021 [2]广西医科大学,南宁530021

出　　处：《实用医学杂志》2021年第22期2928-2933,共6页The Journal of Practical Medicine

基　　金：广西研究生教育创新计划项目(编号:JGY2019058);广西医科大学2019年创新创业训练计划项目(编号:201910598195)。

摘　　要：目的研究分析广西不同地区和民族的乳腺癌患者分子分型及临床病理特征及预后。方法收集2015年1月1日至2018年12月31日在广西医科大学附属肿瘤医院治疗的Ⅰ-Ⅲ期乳腺癌病例1 586例,对比分析4种不同亚型乳腺癌的临床、病理特点以及与预后的关系。结果各亚型比例为Luminal A型14.9%,Luminal B型55.0%,HER2过表达型17.7%,三阴型12.4%。不同分型患者的发病年龄、肿瘤分期、大小、病理类型、淋巴结转移数目比较差异都有统计学意义(均P <0.05)。Cox分析显示,分子分型、肿瘤大小、淋巴结转移数量、激素受体表达情况是影响OS(overall survival)的独立预后因素;分子分型、淋巴结转移数量是影响DFS(disease free survival)的独立危险因素。亚组分析显示,Luminal B型患者中,壮族人群的5年生存率低于汉族人群(94%vs. 97.8%,χ^(2)=4.623,P=0.032);桂南、桂西地区人群的5年生存率优于南宁、桂东、桂北地区人群(χ^(2)=13.805,P=0.008)。结论乳腺癌的预后与分子分型、肿瘤大小、病理类型、淋巴结转移等特征相关;广西各地区、民族间乳腺癌的分型特征无明显差异,但不同地区、民族的生活行为方式及经济状况的差异对部分类型乳腺癌的预后有一定影响。Objective To investigate and analyze the molecular typing,clinicopathological characteristics and prognosis of breast cancer patients from different regions and nationalities in Guangxi Zhuang Autonomous Region. Methods A total of 1,586 cases with stage Ⅰ-Ⅲ breast cancer who were treated in Guangxi Medical University Cancer Hospital from January 1,2015 to December 31,2018 were included in the study. The clinical and pathological characteristics and the relationship with prognosis of four subtype were compared and analyzed.Results The rates of luminal A,luminal B,HER-2 overexpression,and triple negative were 14.9%,55.0%,17.7%,and 12.4%,respectively. There were significant differences in age of onset,tumor stage,tumor size,pathological type and number of lymph node metastasis between the groups(all P < 0.05). Cox analysis showed that molecular typing,tumor size and number of lymph node metastasis were the independent prognostic factors for OS,while molecular typing,lymph node metastasis was the independent prognostic factor for DFS. Subgroup analysis showed that the OS rate of Zhuang nationality was significantly lower than that of Han nationality(5-year OS rate:94% vs.97.8%,χ^(2)= 4.623,P = 0.032). The OS rete of the population living in Southern and Western Guangxi was significantly higher than that living in Nanning,Eastern and Northern Guangxi(χ^(2)= 16.012,P = 0.007). Conclusions The prognosis of breast cancer is related to molecular typing,tumor size,pathological type,lymph node metastasis and other characteristics. There is no significant difference in the classification characteristics of breast cancer in population from different regions and nationalities in Guangxi,but the differences in lifestyle and economic status of different regions and nationalities have a certain impact on the prognosis of some types of breast cancer.

关 键 词：乳腺癌 分子分型 广西地区 预后 

分 类 号：R737.9[医药卫生—肿瘤]