21基因复发风险评分在早期乳腺癌中的应用  

Application of 21-gene recurrence risk score in early breast cancer

作　　者：李琳琳 白雪 赵海东[1] 梁曦 李学璐[1] Linlin Li;Xue Bai;Haidong Zhao;Xi Liang;Xuelu Li(Department of Breast Surgery,Second Affiliated Hospital of Dalian Medical University,Dalian 116027,China)

机构地区：[1]大连医科大学附属第二医院乳腺外科,116027

出　　处：《中华乳腺病杂志(电子版)》2025年第1期33-38,共6页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：国家自然科学基金项目(82203800);辽宁省教育科学“十四五”规划2024年度课题(JG24DB110)。

摘　　要：目的探讨21 基因复发风险评分(RS)在早期乳腺癌患者中的应用,分析其与临床病理特征和预后的相关性。方法按照纳入及排除标准,本研究纳入2019 年1 月至2023 年12 月于大连医科大学附属第二医院乳腺外科行手术治疗及21 基因检测的早期乳腺癌患者122 例进行回顾性分析。根据21 基因检测结果,算出RS, 将所有患者分为低危组(RS<11)、中危组(11≤RS<26)、高危组(RS≥26)。 所有患者随访至2024 年5 月1 日或患者出现复发转移时,了解患者术后辅助治疗、复发转移情况。 分析RS 分级与临床病理特征、辅助化疗选择、复发转移情况的关系。 计数资料的多组比较采用χ^(2)检验或Fisher 确切概率法,等级资料采用多组独立样本的非参数检验(Kruskal-Wallis H 检验)。 多组中的两两比较均经过Bonferroni 校正。 生存分析用Kaplan-Meier 法和Log-rank 检验。结果122 例患者中有19 例为低危组,69 例为中危组,34 例为高危组, 3 组分别有1、12、30 例接受辅助化疗。 112 例(91.8%)未发生腋窝淋巴结转移,10 例(8.2%)伴有腋窝淋巴结转移。 3 组患者的年龄和月经状态比较,差异有统计学意义(χ^(2)=8.936、12.738,P=0.011、0.002)。 在112 例淋巴结阴性的患者中,19 例为低危组,64 例为中危组,29 例为高危组,3 组患者在年龄(χ^(2)=8.916,P=0.012)、月经状态(χ^(2)=12.773,P=0.002)、PR状态(P=0.035)方面差异有统计学意义。 随访时间为26(12, 36)个月,发生3 例局部复发,21 基因检测均为高危组,高危组复发率为8.8%(3/34),无远处转移或死亡事件发生。 对122 例患者进行生存分析的结果显示,低危组、中危组和高危组的无瘤生存曲线比较,差异无统计学意义(P= 0.059)。结论21基因检测RS 分级能为早期乳腺癌患者提供较为可靠的治疗决策依据。ObjectiveTo investigate the application of the 21-gene recurrence risk score (RS) in patients with early breast cancer, and analyze its correlation with clinicopathological characteristics and the prognosis.MethodsBased on the inclusion and exclusion criteria, a total of 122 patients with early breast cancer who underwent surgical treatment and 21-gene testing in the Department of Breast Surgery, the Second Affiliated Hospital of Dalian Medical University from January 2019 to December 2023 were enrolled in this retrospective study. The RS was calculated according to the results of 21-gene testing. All patients were categorized into low-risk group (RS<11), intermediate-risk group (11≤RS<26), and high-risk group (RS≥26). All patients were followed up until May 1, 2024 or until the occurrence of recurrence and metastasis.Information regarding postoperative adjuvant treatment, recurrence, and metastasis was collected. The relationships between RS classification and clinicopathological characteristics, the selection of adjuvant chemotherapy, recurrence, and metastasis were analyzed. For multi-group comparisons of count data, χ^(2) test or Fisher’s exact test was utilized, while rank data was analyzed using the non-parametric test(Kruskal-Wallis H test) for multiple independent samples. Pair-wise comparisons among multiple groups were corrected by the Bonferroni method. Survival analysis was carried out using the Kaplan-Meier method and Log-rank test.ResultsAmong the 122 patients,19 cases were in the low-risk group,69 cases were in the intermediate-risk group, and 34 cases were in the high-risk group, among which 1, 12 and 30 patients received adjuvant chemotherapy. A total of 112 patients (91.8%) had no axillary lymph node metastasis,while 10 patients (8.2%)had axillary lymph node metastasis. Statistically significant differences were observed in age and menstrual status among the three groups (χ^(2)=8.936, 12.738;P=0.011, 0.002). Among the 112 patients with negative lymph nodes, 19 were in the low-risk group,

关 键 词：乳腺肿瘤 基因检测 辅助化疗 预后 

分 类 号：R737.9[医药卫生—肿瘤]