Chen Xiao-Song, Ma Chuan-Dong, Chen Can-Ming
Department of Oncology, Shanghai Medical College, Shanghai 200032, China.
Zhonghua Wai Ke Za Zhi. 2008 Sep 15;46(18):1400-3.
To investigate the relationship between breast cancer molecular classification and prognosis.
From January 2002 to December 2003, 708 female primary breast cancer patients with a mean age of 53 years old were retrospectively analyzed. The classification of breast cancer was according to the immunohistochemical results of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2) status. Molecular classification definitions included highly endocrine responsive, incompletely endocrine responsive, triple negative, and HER2 positive. The prognosis among different molecular classifications of breast cancer was investigated. The survival rates of different classifications were compared by Log-rank test.
The proportion of highly endocrine responsive, incompletely endocrine responsive, HER2 positive and triple-negative breast cancer was 33.2% (235/708), 23.6% (167/708), 21.3% (151/708) and 21.9% (155/708). The follow-up period were from 3 to 68 months with a median of 40.2 months. A total of 100 cases were identified to had disease recurrence or death. Factors affecting the prognosis were tumor size, axillary lymph node status, molecular classification, adjuvant radiotherapy and adjuvant endocrine therapy by univariate analysis. Multivariate analysis revealed that the molecular classification and lymph node status were the independent prognostic factors with the hazard ratio 1.205 (P = 0.047) and 4.512 (P = 0.000), respectively. Survival analysis showed that highly endocrine responsive breast cancer was with superior prognosis versus others.
Molecular classification of breast cancer is an independent predictor of prognosis. Breast cancer patients classified as highly endocrine responsive subtype have the best outcome.
探讨乳腺癌分子分类与预后的关系。
回顾性分析2002年1月至2003年12月期间708例平均年龄53岁的女性原发性乳腺癌患者。乳腺癌的分类依据雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体(HER2)状态的免疫组化结果。分子分类定义包括高度内分泌反应型、不完全内分泌反应型、三阴性和HER2阳性。研究乳腺癌不同分子分类的预后情况。采用对数秩检验比较不同分类的生存率。
高度内分泌反应型、不完全内分泌反应型、HER2阳性和三阴性乳腺癌的比例分别为33.2%(235/708)、23.6%(167/708)、21.3%(151/708)和21.9%(155/708)。随访时间为3至68个月,中位时间为40.2个月。共确定100例出现疾病复发或死亡。单因素分析显示,影响预后的因素有肿瘤大小、腋窝淋巴结状态、分子分类、辅助放疗和辅助内分泌治疗。多因素分析显示,分子分类和淋巴结状态是独立的预后因素,风险比分别为1.205(P = 0.047)和4.512(P = 0.000)。生存分析表明,高度内分泌反应型乳腺癌的预后优于其他类型。
乳腺癌的分子分类是预后的独立预测因素。分类为高度内分泌反应型亚型的乳腺癌患者预后最佳。