中国实用外科杂志

中国实用外科杂志

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乳腺癌改良根治术后其分子亚型年复发风险分析

方    琦，王旭芬   

  1. 苏州大学附属第三医院 常州市第一人民医院，江苏常州213000
  • 发布日期:2012-10-19

  • Published:2012-10-19

摘要：

目的    探讨改良根治术后的乳腺癌免疫组化各分子亚型的预后特性和年复发变化。方法    回顾性分析2003年1月至2008年8月常州市第一人民医院应用改良根治术治疗310例乳腺癌的临床资料。根据免疫组化雌激素受体（ER）、孕激素受体（PR）和人类表皮生长因子受体2（HER2）的检测结果分为luminal型、HER2阳性型、三阴性乳腺癌，对比分析不同亚型乳腺癌的临床复发风险。 结果    310例乳腺癌总体年复发风险高峰在2年左右，5年有一个平稳的小高峰。免疫组化各分子亚型HER2阳性年复发风险最高，三阴性乳腺癌次之，Luminal型复发风险最低（P<0.05）。HER2阳性型年复发风险最高，但是复发高峰在2~3年，之后直线下降；三阴性乳腺癌复发高峰虽然较HER2阳性型低，但是维持在2~5年复发，延时较长。 结论    免疫组化的各分子亚型对乳腺癌临床复发起不同的预后指导作用。

关键词: 乳腺癌, 免疫组化分子, 亚型

Abstract:

Evaluation of annual recurrence risk for breast cancer patients classified by immunohistochemistry molecular subtypes after radical mastectomy        FANG Qi, WANG Xu-fen. Department of Breast Surgery, the Third Affiliated Hospital of Suzhou University, Changzhou 213000, China
Corresponding author: WANG Xu-fen, E-mail:493835745@qq.com
Abstract    Objective    To analyze the prognosis feature and annual recurrence risk for breast cancer patients classified by immunohistochemistry molecular subtypes after radical mastectomy. Methods    The clinical data of 310 cases of female unilateral breast cancer performed modified radical mastectomy between January 2003 and August 2008 in the First People’s Hospital of Changzhou were analyzed retrospectively. All the cases were classified as luminal, HER2+ and triple negative subtypes according to their immunohistochemistry results of ER, PR and HER2. Survival curves were performed with Kaplan-Meier method and annual recurrence hazard was estimated by hazard function. Results    Annual recurrence hazard curve for entire population showed a double-peaked pattern, with a first major recurrence surge reaching the maximum at the second year after surgery and a second low recurrence peak near the 5th year. Compared with luminal subtype, HER+ subtype had a much higher annual recurrence peak. The annual recurrence peak of triple negative subtype breast cancer, though lower than HER2+ subtype, was still higher than luminal subtype. The peak of HER2+ subtype decreased vastly after 2-3 years. Triple negative subtype had a relative stable peak from 2-5 year. Conclusion    The annual recurrence features of breast cancer subtypes can provide different guidance for prognosis.

Key words: breast cancer, immunohistochemistry, subtype