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luminalA型，luminalB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luminalA型63例，luminalB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luminalA型28．6％（18／63），luminalB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luminalA型68．3％（43／63），luminalB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，luminalB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，luminalA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。luminalB型更容易发生骨转移。
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 recur rence 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 recur- rence among the 4 subtypes clinical subtypes （P 〈 0.01 ）.There is significantly difference in simple bone metasta sis 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 lon- ger 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.
出处
《实用肿瘤学杂志》
CAS
2010年第6期506-511,共6页
Practical Oncology Journal
基金
基金项目：天津市科技支撑重大项目（09ZCZDSF04000）
关键词
乳腺癌
临床分型
复发
转移
Breast cancer
Clinical subtype
Recurrence
Metastasis
