摘要
目的探讨人表皮生长因子受体2(HER2)阳性早期乳腺癌患者预后的影响因素。方法收集121例HER2阳性早期乳腺癌患者的临床资料,所有患者均接受了手术和曲妥珠单抗治疗,并对全部患者进行了随访。结果121例HER2阳性早期乳腺癌患者中无失访病例,2例患者发生局部复发,22例患者发生远处转移,12例患者死亡。121例HER2阳性早期乳腺癌患者的无病生存(DFS)率、无远处转移生存(DDFS)率分别为80.2%(97/121)、81.8%(99/121)。单因素分析结果显示,年龄≤35岁、组织学分级为Ⅲ级、肿瘤最大径﹥2 cm、腋窝淋巴结转移阳性的HER2阳性早期乳腺癌患者的DFS率均低于年龄﹥35岁、组织学分级为Ⅰ~Ⅱ级、肿瘤最大径≤2 cm、腋窝淋巴结转移阴性的患者(P﹤0.05);年龄≤35岁、腋窝淋巴结转移阳性HER2阳性早期乳腺癌患者的DDFS率均低于年龄﹥35岁、腋窝淋巴结转移阴性的患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,年龄≤35岁和组织学分级为Ⅲ级是HER2阳性早期乳腺癌患者DFS率低的独立危险因素(P﹤0.05)。结论接受曲妥珠单抗治疗后,HER2阳性早期乳腺癌的预后较好,年龄≤35岁和组织学分级高是HER2阳性早期乳腺癌患者DFS短的独立危险因素。预后风险评分有助于更加准确地评估HER2阳性早期乳腺癌患者的预后。
Objective To investigate the prognostic factors of early human epidermal growth factor receptor 2(HER2)positive breast cancer patients.Method The clinical data of 121 patients with early HER2 positive breast cancer were retrospectively analyzed.All patients were treated with surgery and trastuzumab.All patients were followed up.Result None of the 121 cases had lost to follow-up,and there were 2 patients with local relapse,22 had distant metastases,and 12 cases of death.The disease-free survival(DFS)rate,distant disease-free survival(DDFS)rate among the 121 cases were 80.2%(97/121)and 81.8%(99/121),respectively.Univariate analysis indicated that,age≤35,histological grade III,maximum tumor diameter>2 cm and presence of positive axillary lymph node metastasis were associated with lower DFS rate compared to those with age>35,histological grade I-II,maximum tumor diameter≤2 cm,and negative axillary lymph node metastasis(P<0.05);age≤35 and positive axillary lymph node metastasis were related to lower DFS rate compared to those with age>35 and negative axillary lymph node metastasis(P<0.05).Multivariate analysis revealed that,age≤35 and histological stage III were the independent risk factors for lower DFS rate of early HER2 positive breast cancer patients receiving trastuzumab.Conclusion After receiving trastuzumab,early HER2 positive breast cancer patients may have rather good prognosis,still,age≤35 and high histological grade are the independent risk factors for short DFS.Prognostic risk scoring would be helpful for evaluating the prognosis of early HER2 positive breast cancer patients more accurately.
作者
欧开萍
罗扬
吕剑虹
桑蝶
刘维丽
张金涛
周华
蔡有菊
OU Kaiping;LUO Yang;LYU Jianhong;SANG Die;LIU Weili;ZHANG Jintao;ZHOU Hua;CAI Youju(Department of Medical Oncology,Beijing Chaoyang District Sanhuan Cancer Hospital,Beijing 100122,China;Department of Medical Oncology,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《癌症进展》
2019年第16期1935-1938,1966,共5页
Oncology Progress
关键词
乳腺癌
早期
人表皮生长因子受体2
曲妥珠单抗
预后
breast cancer
early stage
human epidermal growth factor receptor 2
trastuzumab
prognosis
