临床研究(Clinical Research)

乳腺浸润性导管癌分子亚型与腋窝淋巴结转移的关系

Published at: 2016年第25卷第5期

王红鲜 1 , 李呈英 1 , 王开昕 2 , 齐柯 1 , 张好云 1 , 冯铎 1 , 卫文俊 1 , 陈天文 1 , 林秋生 1
1 广东医科大学附属深圳南山医院甲乳外科 ,广东 深圳 518052
2 广东医科大学附属深圳南山医院病理科,广东 深圳 518052
通讯作者 红鲜 王 Email: hnsmx001@yeah.net
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.05.013
基金:
广东省医学科研基金资助项目 A2014664

摘要

目的:探讨乳腺浸润性导管癌不同分子亚型与其腋窝淋巴结转移的关系。方法:根据乳腺癌分子分型标准,将243例原发乳腺浸润性导管癌的手术患者分为Luminal A型、Luminal B型[又分为HER-2(-)和HER-2(+)]、HER-2过表达型和三阴型。结合临床病理资料,分析各分子亚型的分布特点,以及与腋窝淋巴结转移的关系。结果:243例患者中,Luminal B [HER-2(-)]型最多(78例,32.1%),其次是Luminal A型(58例,23.87%),随后为三阴型(41例,16.87%)、HER-2过表达型(34例,13.99%)、Luminal B [HER-2(+)]型(32例,13.17%);94例(38.68%)发生腋窝淋巴结转移,各分子亚型患者腋窝淋巴结转移发生率差异有统计学意义(P<0.05),其中Luminal B [HER-2(-)]型(42例,53.85%)和Luminal B [HER-2(+)]型(15例,46.88%)中发生率最高,且两者间差异无统计学意义(P>0.05),其后依次为Luminal A型(19例,32.76%),三阴型(12例,29.27%),HER-2过表达型(6例,17.65%);各分子亚型分布在累及1~3枚及≥4枚淋巴结转移的分组中,差异均无统计学意义(均P>0.05),但前者Luminal B [HER-2(+)]型最多,HER-2过表达型最少,而后者HER-2过表达型最多,Luminal B [HER-2(+)]型最少。结论:乳腺浸润性导管癌的分子分型对评估腋窝淋巴结转移状况、判断疾病状态有一定参考价值,可成为制定个体化诊治策略的依据。


Relationship between molecular subtypes of breast invasive ductal carcinoma and axillary lymph node metastasis

Abstract

Objective: To investigate the relationship between different molecular subtypes of breast invasive ductal carcinoma (IDC) and axillary lymph node metastasis. Methods: According to the molecular classification criteria of breast cancer, the 243 patients with primary breast IDC undergoing surgical treatment were divided into luminal A, luminal B [further subdivided into HER-2 (–) and HER-2 (+)], HER-2 over expression and triple-negative type. Combining with the clinical pathological data, the distribution characteristics of various molecular subtypes, and the relations of different molecular subtypes with axillary lymph node metastasis were analyzed. Results: Among the 243 patients, cases with Luminal B [HER-2 (–)] type accounted for the majority (78 cases, 32.1%), and Luminal A type was the next (58 cases, 23.87%), followed by triple-negative (41 cases, 16.87%), HER-2 over expression (34 cases, 13.99%) and Luminal B [HER-2(+)] type (32 cases, 13.17%), successively. Axillary lymph node metastasis occurred in 94 cases (38.68%), and the incidence of axillary lymph node metastasis was statistically different among patients with different molecular subtypes (P<0.05). It was highest in those with luminal B [HER-2 (–)] (42 cases, 53.85%) or Luminal B [HER-2 (+)] type (15 cases, 46.88%), with no statistical difference between them (P>0.05), followed by Luminal A (19 cases, 32.76%), triple-negative (12 cases, 29.27%) and HER-2 over expression type (6 cases, 17.65%), successively; no significant difference was found in distribution of the molecular subtypes either in group of patients with involvement of 1 lymph node to 3 lymph nodes or ≥ 4 lymph nodes (both P>0.05), although the number of cases with Luminal B [HER-2 (+)] type was highest and HER-2 over- expression type was lowest in the former, while the number of cases with HER-2 over- expression type was highest and Luminal B [HER-2(+)] type was lowest in the latter. Conclusion: In breast IDC, molecular subtype has certain reference value for assessing axillary lymph node metastasis and judging disease status, and it can probably be used as a basis for making individualized diagnosis and treatment strategy.


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引用

引用本文: 红鲜 王, 呈英 李, 开昕 王, 柯 齐, 好云 张, 铎 冯, 文俊 卫, 天文 陈, 秋生 林. 乳腺浸润性导管癌分子亚型与腋窝淋巴结转移的关系[J]. 中国普通外科杂志, 2016, 25(5): 699-704.
Cite this article as: WANG Hongxian, LI Chengying, WANG Kaixin, QI Ke, ZHANG Haoyun, FENG Duo, WEI Wenjun, CHEN Tianwen, LIN Qiusheng . Relationship between molecular subtypes of breast invasive ductal carcinoma and axillary lymph node metastasis[J]. Chin J Gen Surg, 2016, 25(5): 699-704.