Yang Qian, Chen Jie, Li Hong-Jiang, Yu Miao, Tian Chun-Xiang, Lü Qing
Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Zhong Liu Za Zhi. 2011 Jan;33(1):42-6.
To investigate the clinical characteristics and prognosis of different breast cancer molecular subtypes.
Clinicopathological and follow-up data of 1153 cases of operable breast cancer were analyzed retrospectively. Their molecular subtypes were categorized as luminal A, luminal B, Her-2 over-expressing and basal-like subtypes, based on detection of ER, PR, Her-2 expression. The correlation of prognosis of different molecular subtypes with age, tumor size, lymph node status and clinical staging was analyzed.
Among the 1153 cases, 791 cases (68.6%) were of luminal A subtype, 50 cases (4.3%) luminal B subtype, 53 cases (4.6%) Her-2(+)subtype, and 259 cases (22.5%) basal-like subtype. There were no statistically significant differences among different molecular subtypes regarding the age, tumor size, lymph node status, and clinical stage. 1006 cases had complete follow-up data and the analysis showed that distant metastasis of Her-2 over-expressing subtype was significantly higher than that in other subtypes (P = 0.005), but the differences of local recurrence rate in different molecular subtypes was not statistically significant (P > 0.05). Kaplan-Meier method was used to analyze the survival prognosis of different molecular subtypes, showing both DFS rate and OS rate of Her-2 over-expressing subtype were the lowest, with a statistically significant difference (Log rank test, P < 0.05). Univariate and multivariate analyses showed that molecular typing and lymph node status were independent prognostic factors affecting both DFS and OS.
Her-2 over-expressing subtype has the worst prognosis. Molecular subtypes may provide important information to predict the prognosis of breast cancer and might be an important basis for individualized treatment of breast cancer in future.
探讨不同乳腺癌分子亚型的临床特征及预后。
回顾性分析1153例可手术乳腺癌患者的临床病理及随访资料。根据雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（Her-2）表达检测结果，将其分子亚型分为腔面A型、腔面B型、Her-2过表达型和基底样型。分析不同分子亚型的预后与年龄、肿瘤大小、淋巴结状态及临床分期的相关性。
1153例患者中，腔面A型791例（68.6%），腔面B型50例（4.3%），Her-2（+）型53例（4.6%），基底样型259例（22.5%）。不同分子亚型在年龄、肿瘤大小、淋巴结状态及临床分期方面差异无统计学意义。1006例有完整随访资料，分析显示Her-2过表达型远处转移率显著高于其他亚型（P = 0.005），但不同分子亚型局部复发率差异无统计学意义（P > 0.05）。采用Kaplan-Meier法分析不同分子亚型的生存预后，显示Her-2过表达型无病生存率（DFS）和总生存率（OS）均最低，差异有统计学意义（Log秩检验，P < 0.05）。单因素和多因素分析显示，分子分型和淋巴结状态是影响DFS和OS的独立预后因素。
Her-2过表达型预后最差。分子亚型可为预测乳腺癌预后提供重要信息，可能成为未来乳腺癌个体化治疗的重要依据。
