实用肿瘤学杂志 ›› 2010, Vol. 24 ›› Issue (6): 506-511.doi: 10.3969/j.issn.1002-3070.2010.06.002

• 论著 • 上一篇    下一篇

乳腺癌不同临床亚型术后局部复发特征的对比分析

王晓庆, 张晟, 朱元喜, 刘艳, 郝晓甍, 张瑾   

  1. 天津医科大学附属肿瘤医院(天津 300060);中国天津乳腺癌防治研究中心;乳腺癌防治教育部重点实验室;天津市肿瘤防治重点实验室
  • 收稿日期:2010-10-19 出版日期:2010-12-28 发布日期:2015-01-24
  • 通讯作者: 张瑾,E-mail:davidz9132002@yahoo.com
  • 作者简介:王晓庆,男,(1985-),硕士研究生,从事乳腺癌临床与基础研究
  • 基金资助:
    天津市科技支撑重大项目(09ZCZDSF04000)

Analysis of local-regional recurrence in different clinical subtypes breast cancer after surgical operation

WANG Xiaoqing, ZHANG Shen, ZHU Yuanxi, LIU Yan, HAO Xiaomeng, ZHANG Jin   

  • Received:2010-10-19 Online:2010-12-28 Published:2015-01-24

摘要: 目的 研究乳腺癌不同临床亚型术后局部复发的不同特征,从而针对不同临床亚型制定不同治疗方案。方法 回顾性分析天津肿瘤医院2002年7月—2005年2月期间收治的477例乳腺癌术后复发患者,通过免疫组化方法分为luminal A型,luminal B型,HER-2(+)型,基底样型,分析各亚型之间局部复发的不同特征。结果 477例复发病例中,1年内复发率26.2%(125/477),2年内复发率61.2%(292/477),2年以上复发率38.8%(185/477)。按照临床分型luminal A型63例,luminal B型67例,HER-2(+)型110例,基底样型237例,各亚型在2年内和2年以上复发率之间的差异有统计学意义(P<0.01)。局部复发后转移例数共310例,占65.0%(310/477),复发后转移率luminal A型28.6%(18/63),luminal B型40.3%(27/67),HER-2(+)型60.9%(67/110),基底样型83.5%(198/237),各亚型复发后转移率之间的差异有统计学意义(P<0.01)。各亚型单纯骨转移组的差异有统计学意义(P<0.01),而单纯肺转移、单纯肝转移和多部位转移发生率的差异无统计学意义(P>0.05)。各亚型复发后疾病进展时间的差异有统计学意义(P<0.05)。复发后5年总生存率48.4%(231/477),各亚型生存率luminal A型68.3%(43/63),luminal B型62.7%(42/67),HER-2(+)型49.1%(54/110),基底样型38.8%(92/237),各亚型生存率之间的差异有统计学意义(P<0.01)。结论 乳腺癌术后2年内是复发的高峰期。基底样型乳腺癌最易复发,复发后转移率最高,疾病进展时间最短,且生存率最低,HER-2(+)型次之,luminal B型复发率较低,复发后转移较少,疾病进展较慢且生存率较高,luminal A型复发率最低,复发后转移最少,疾病进展最慢且生存率最高。luminal B型更容易发生骨转移。

Abstract: Objective This study focuses on different characteristics of different clinical subtypes breast cancer with local-regional recurrence after breast cancer operation,in order to give different treatments according to different clinical subtypes.Methods From 2007.1 to 2005.2,477 female patients with loco-regional recurrence of breast cancer in Tianjin cancer hospital were analyzed retrospectively,which was divided into luminal A type,luminal B type,HER-2(+)-type,basal-like type by immunohistochemical method.The subtypes were analyzed associated with local recurrence.Results In 477 cases of recurrence,recurrence rate within 1 year is 26.2%,recurrence rate within 2 years is 61.2%,recurrence rate after 2 years is 38.8%.In accordance with clinical types,luminal A type includes 63 cases,luminal B type includes 67 cases,HER-2(+)-type includes 110 cases,basal-like type includes 237cases,there is significantly difference among the 4 subtypes of recurrent rate within and after 2 years(P<0.01).There are 310 cases metastasized after local recurrence,accounting for 65.0%.Metastasis rate after local recurrence is 28.6% in luminal A type,40.3% in luminal B type,60.9% in HER-2(+)type,83.5% in basal-like type.There is significantly difference of the metastasis rate after recurrence among the 4 subtypes clinical subtypes(P<0.01).There is significantly difference in simple bone metastasis group(P<0.01),There is no significantly difference among different groups of simple lung metastasis,liver metastasis and multiple-site metastasis(P>0.05).Difference of disease progression time among different clinical subtypes is statistically significant(P<0.05).5-year total survival rate after recurrence is 48.4%,5-year survival rate of luminal A type is 68.3%,luminal B type is 62.7%,HER-2(+)-type is 49.1%,basal-like type is 38.8%,There is significantly difference of the survival rate among different clinical subtypes(P<0.01).Conclusion Among the recurrence cases,most of them happen in 2 years after breast cancer operation.Basal-like type breast cancer is the easiest one to relapse,which the metastasis rate after recurrence is the highest one,disease progression time is the shortest and survival rate is the lowest,HER-2(+)-type followed.Recurrence rate of luminal B type is lower,which the metastasis rate after recurrence is lower,disease progression time is longer and the survival rate is higher.Recurrence rate of luminal A type is the lowest one,which the metastasis rate after recurrence is the lowest one,disease progression time is the longest and the survival rate is the highest.Luminal B type is more likely to metastasize to the bone.

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