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乳腺癌患者的突变:预后因素与生存分析

mutation in breast cancer patients: Analysis of prognostic factors and survival.

作者信息

Huszno Joanna, Kołosza Zofia, Grzybowska Ewa

机构信息

Outpatient Clinic, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland.

Biostatistics Unit, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, 44-101 Gliwice, Poland.

出版信息

Oncol Lett. 2019 Feb;17(2):1986-1995. doi: 10.3892/ol.2018.9770. Epub 2018 Nov 28.

Abstract

The presence of BRCA1 mutations is associated with an increased risk of breast and ovarian cancer. The present study compared clinicopathological characteristics and overall survival (OS) of hereditary and sporadic breast cancer. Using data collected from a previous study conducted between 2007-2016 at the Maria Skłodowska Curie Cancer Center and Institute of Oncology (Gliwice, Poland), the prognostic factors and survival in 60 breast cancer mutation carriers were analyzed. A control group was selected from the breast cancer patients without BRCA mutations (n=386). BRCA mutation carriers had significantly worse survival when compared with non-carriers (P=0.017). The 10-year OS rate was 78.0% for all analyzed groups: 65.9% for BRCA mutation carriers and 81.1% for non-carriers. In the univariate analyses, BRCA mutation carriers had a significantly higher risk of mortality in comparison to non-carriers [hazard ratio (HR)=1.87; 95% confidence interval (CI) 1.08-3.25]. Increased tumor size (HR=3.64), lymph node metastases (HR=2.45) and higher histological grade (HR=2.84) were significant factors for worse OS. Positive estrogen receptor status was associated with a better OS (HR=0.49, P=0.022). Age ≤40 years (HR=0.48, P=0.081) was an insignificantly favorable factor. The 10-year survival rate was significantly decreased in patients with BRCA1 mutation. Therefore, negative factors for OS in mutation carriers included lymph nodes metastases, negative steroid receptor status and increased tumor size.

摘要

BRCA1基因突变的存在与乳腺癌和卵巢癌风险增加相关。本研究比较了遗传性和散发性乳腺癌的临床病理特征及总生存期(OS)。利用2007年至2016年期间在玛丽亚·斯克洛多夫斯卡·居里癌症中心和肿瘤研究所(波兰格利维采)进行的一项先前研究收集的数据,分析了60例乳腺癌突变携带者的预后因素和生存期。从无BRCA突变的乳腺癌患者中选取对照组(n = 386)。与非携带者相比,BRCA突变携带者的生存期明显更差(P = 0.017)。所有分析组的10年总生存率为78.0%:BRCA突变携带者为65.9%,非携带者为81.1%。在单因素分析中,与非携带者相比,BRCA突变携带者的死亡风险显著更高[风险比(HR)= 1.87;95%置信区间(CI)1.08 - 3.25]。肿瘤大小增加(HR = 3.64)、淋巴结转移(HR = 2.45)和更高的组织学分级(HR = 2.84)是总生存期较差的显著因素。雌激素受体阳性状态与更好的总生存期相关(HR = 0.49,P = 0.022)。年龄≤40岁(HR = 0.48,P = 0.081)是一个不显著的有利因素。BRCA1突变患者的10年生存率显著降低。因此,突变携带者总生存期的负面因素包括淋巴结转移、类固醇受体阴性状态和肿瘤大小增加。

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