Zuo T T, Zeng H M, Zheng R S, Yang L, Li H C, Liu S, Xia C F, Chen W Q
National Office for Cancer Prevention and Control, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 May 6;51(5):409-414. doi: 10.3760/cma.j.issn.0253-9624.2017.05.008.
To analyze the associations between molecular subtypes and overall breast cancer survival among premenopausal and postmenopausal breast cancer in Beijing, and to provide basic information for breast cancer clinical researches and control. All the resident patients diagnosed with breast cancer in four well-established hospitals were retrieved from Beijing cancer registry, related information, such as TNM stages, receptor status, histological grade, height, weight, were collected by case extraction. Cancer registration information and population-based follow-up information were used to acquire survival outcome. All the patients were followed up until 31 December 2015, 4 531 cases with invasive, primary breast were included in the final analysis. All the cases were classified into Luminal and non-Luminal according to receptor status. Five-year survival rates of the two subtypes were estimated by the life-table method. Multivariable Cox proportional hazards models were employed to evaluate the associations between molecular subtypes and breast cancer survival. Of all the 4 531 patients, premenopausal patients accounted for 44.5% (2 017 cases) and postmenopausal patients accounted for 55.5% (2 514 cases). 643 cases died during the study period. Overall five-year survival was 89.5% (95 88.6%-90.4%), for premenopausal and postmenopausal patients, they were 92.1% (95 90.9%-93.3%), and 87.5% (95 86.2%-88.8%), respectively. Among all the patients, 3 730 patients had molecular subtype, 76.7% (2 861 cases) were Luminal breast cancer, and 23.3% (869 cases) were non-Luminal breast cancer. Five-year survival rates for Luminal and non-Luminal were 91.8% (95 90.8%-92.8%), and 83.2% (95 80.7%-85.7%), respectively. No matter in premenopausal or postmenopausal patients, non-Luminal breast cancer had significantly higher risk of death compared to Luminal breast cancer (premenopausal: 1.85, 95 1.26-2.73; premenopausal: 1.42, 95 1.07-1.88). For both premenopausal and postmenopausal breast cancer patients, non-Luminal breast cancer had lower five-year survival rates than Luminal breast cancer, which was a risk factor on breast cancer survival.
分析北京地区绝经前和绝经后乳腺癌分子亚型与总体生存情况的关联，为乳腺癌临床研究和防治提供基础资料。从北京肿瘤登记处检索出在4家知名医院确诊为乳腺癌的所有本地患者，通过病例提取收集TNM分期、受体状态、组织学分级、身高、体重等相关信息。利用癌症登记信息和基于人群的随访信息获取生存结局。所有患者随访至2015年12月31日，最终纳入4531例浸润性原发性乳腺癌病例进行分析。所有病例根据受体状态分为Luminal型和非Luminal型。采用寿命表法估计两亚型的5年生存率。应用多变量Cox比例风险模型评估分子亚型与乳腺癌生存的关联。在全部4531例患者中，绝经前患者占44.5%（2017例），绝经后患者占55.5%（2514例）。研究期间643例患者死亡。总体5年生存率为89.5%（95%CI 88.6%-90.4%），绝经前和绝经后患者分别为92.1%（95%CI 90.9%-93.3%）和87.5%（95%CI 86.2%-88.8%）。在所有患者中，3730例有分子亚型，76.7%（2861例）为Luminal型乳腺癌，23.3%（869例）为非Luminal型乳腺癌。Luminal型和非Luminal型的5年生存率分别为91.8%（95%CI 90.8%-92.8%）和83.2%（95%CI 80.7%-85.7%）。无论绝经前还是绝经后患者，非Luminal型乳腺癌的死亡风险均显著高于Luminal型乳腺癌（绝经前：1.85，95%CI 1.26-2.73；绝经后：1.42，95%CI 1.07-1.88）。对于绝经前和绝经后乳腺癌患者，非Luminal型乳腺癌的5年生存率均低于Luminal型乳腺癌，这是影响乳腺癌生存的一个危险因素。
