不同激素水平Her-2阳性乳腺癌复发转移情况及预后分析  

Analysis of recurrence and metastasis and prognosis of Her-2 positive breast cancer with different hormones levels

作　　者：白力允[1] 白力丹 谢静 邢俊领[1] 宋士军[1] BAI Liyun;BAI Lidan;XIE Jing;XING Junling;SONG Shijun(Department of Oncology,the Third Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453000,China;Diagnostic Teaching and Research Room,Clinical College,Sanquan College,Xinxiang Medical University,Xinxiang,Henan 453003,China)

机构地区：[1]新乡医学院第三附属医院肿瘤内科,河南新乡453000 [2]新乡医学院三全学院临床学院诊断教研室,河南新乡453003

出　　处：《现代医药卫生》2021年第24期4196-4199,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨不同病理特征及激素水平人类表皮生长因子受体(Her-2)阳性乳腺癌患者复发转移情况及其预后。方法选择2015年2月至2017年2月78例Her-2阳性乳腺癌患者为研究对象,患者均予以根治术及术后辅助治疗,按照雌激素受体(ER)、孕激素受体(PR)表达水平分为HR^(+)/Her-2^(+)组(43例)及HR-/Her-2^(+)组(35例),分析2组患者的病理特征及相关激素、蛋白表达情况,并以手术治疗为观察点,患者均随访3年,统计随访期间2组存活情况,并记录复发转移情况,包括局部复发、首次多发及转移器官等。结果HR^(+)/Her-2^(+)组患者中ER^(+)/PR^(+)双表达占67.44%,且该组患者的肿瘤直径>2 cm的比例、术时腋窝淋巴结阳性比例及绝经后状态、诊断时Ki-67高表达率分别为60.47%、53.49%、41.86%、34.88%,均低于HR-/Her-2^(+)组患者的82.86%、77.14%、65.71%、57.14%(P<0.05)。HR^(+)/Her-2^(+)组患者的3年存活率为72.09%,显著高于HR-/Her-2^(+)组的48.57%(P<0.05);HR^(+)/Her-2^(+)组的合并骨转移发生率为83.33%,显著高于HR-/Her-2^(+)组的38.23%,其肺转移发生率(12.50%)则显著低于HR-/Her-2^(+)组的37.50%(P<0.05)。以上述因素进行二项logistic回归分析,结果显示肿瘤直径>2 cm、术时腋窝淋巴结阳性、HR阳性、诊断时Ki-67高表达均为影响患者预后的危险因素(P<0.05)。结论HR阴性的Her-2阳性乳腺癌患者预后往往较差,更容易发生内脏转移,3年存活率低于HR阳性的Her-2阳性乳腺癌患者。Objective To explore the recurrence and metastasis and prognosis of Her-2 positive breast cancer patients with different hormones levels.Methods Seventy-eight cases with Her-2 positive breast cancer were selected in the Third Affiliated Hospital of Xinxiang Medical College from February 2015 to February 2017 as the research subjects.All patients received radical surgery and postoperative adjuvant therapy,and they were divided into the HR^(+)/Her-2^(+) group(43 cases)and the HR-/Her-2^(+) group(35 cases)according to expression levels of estrogen receptor(ER)and progesterone(PR).The pathological characteristics and related hormones and protein expression were analyzed in the two groups,and the surgical treatment was used as the observation point,and the patients were followed up for 3 years.The survival status of the two groups was statistically analyzed during follow-up,and the recurrence and metastasis were recorded,including local recurrence,first multiple recurrence and metastatic organs.Results In the HR^(+)/Her-2^(+) group,the proportion of ER^(+)/PR^(+) double expression accounted for 67.44%,the proportion of tumor diameter>2 cm,the proportion of positive axillary lymph nodes during surgery and Ki-67 high expression rates at postmenopausal state and during diagnosis were 60.47%,53.49%,41.86%and 34.88%respectively,which were lower than 82.86%,77.14%,65.71%and 57.14%in the HR-/Her-2^(+) group(P<0.05).The 3-year survival rate of patients in the HR^(+)/Her-2^(+) group was significantly higher than that in the HR-/Her-2^(+) group(72.09%vs.48.57%),the difference was statistically significant(P<0.05).The combined bone metastasis rate in the HR^(+)/Her-2^(+) group was significantly higher than that in the HR-/Her-2^(+) group(83.33%vs.38.23%),and the lung metastasis rate was significantly lower than that in the HR-/Her-2^(+) group(12.50%vs.37.50%),the differences were statistically significant(P<0.05).Binary logistic regression analysis was conducted with the above factors,and the results showed that tumor diameter>2

关 键 词：乳腺癌 雌激素 孕激素 淋巴结 存活率 预后因素 

分 类 号：R730.7[医药卫生—肿瘤]