Jia Wei-Juan, Jia Hai-Xia, Feng Hui-Yi, Yang Ya-Ping, Chen Kai, Su Feng-Xi
Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University , Guangzhou, China E-mail :
Asian Pac J Cancer Prev. 2014;15(1):315-20. doi: 10.7314/apjcp.2014.15.1.315.
The purpose of this study was to investigate the recurrence pattern and characteristics of patients based on the 2013 St. Gallen surrogate molecular subtypes after breast-conserving surgery (BCS) in Chinese women.
This retrospective analysis included 709 consecutive breast cancer patients undergoing BCS from 1999-2010 at our institution. Five different surrogate subtypes were created using combined expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2. Locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates were calculated.
The 5-year LRRFS, DMFS, and DFS rates were 90.5%, 88.2%, and 81.5%, respectively. Multivariate analysis revealed that young age, node-positive disease, and HER2 enrichment were independent prognostic factors in LRRFS patients. There was also an independent prognostic role of lymph node-positive disease in DMFS and DFS patients. Patients with luminal A tumors had the most favorable prognosis, with LRRFS, DMFS, and DFS rates of 93.2%, 91.5%, and 87.5% at 5 years, respectively. Conversely, HER-2-enriched tumors exhibited the highest rate of recurrence (27.5%) and locoregional recurrence (11.4%).
Surrogate subtypes present with significant differences in RFS, DMFS, and LRRFS. Luminal A tumors have the best prognosis, whereas HER2-enriched tumors have the poorest.
本研究旨在调查中国女性保乳手术（BCS）后基于2013年圣加仑替代分子亚型的患者复发模式和特征。
这项回顾性分析纳入了1999年至2010年在我院连续接受BCS的709例乳腺癌患者。利用雌激素受体、孕激素受体和人表皮生长因子受体-2的联合表达创建了五种不同的替代亚型。计算局部区域无复发生存率（LRRFS）、远处转移无复发生存率（DMFS）和无病生存率（DFS）。
5年LRRFS、DMFS和DFS率分别为90.5%、88.2%和81.5%。多变量分析显示，年轻、淋巴结阳性疾病和HER2富集是LRRFS患者的独立预后因素。淋巴结阳性疾病在DMFS和DFS患者中也具有独立的预后作用。腔面A型肿瘤患者预后最佳，5年LRRFS、DMFS和DFS率分别为93.2%、91.5%和87.5%。相反，HER-2富集型肿瘤的复发率（27.5%）和局部区域复发率（11.4%）最高。
替代亚型在RFS、DMFS和LRRFS方面存在显著差异。腔面A型肿瘤预后最佳，而HER2富集型肿瘤预后最差。
