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 differen
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
