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目的探讨乳腺癌不同分子亚型腋窝淋巴结转移的状态及预后分析。方法对2005年1月2007年12月收治的125例乳腺癌患者进行分子分型,对腋窝淋巴结转移状态进行分析并结合随访结果进行预后分析。结果 Luminal A型63例,16例淋巴结转移,转移率为25.4%;Luminal B型19例,7例淋巴结转移,转移率为36.8%;HER-2过表达型26例,11例淋巴结转移,转移率为42.3%;Basal-like型17例,9例淋巴结转移,转移率为52.9%。其中Luminal A型淋巴结转移率与Basal-like型比较差异有统计学意义(P<0.05),其余型间比较差异无统计学意义(P>0.05)。运用χ2检验各分子亚型在肿瘤大小的差异无统计学意义(P>0.05)。经过2～5年随访,8例患者出现局部复发或远处转移,其中Luminal B型2例,HER-2过表达型5例,Basal-like型1例。8例中有3例因肝转移死亡,另5例接受治疗现仍生存。结论乳腺癌的分子分型可作为腋窝淋巴结转移的预测指标,HER-2过表达型和Basal-like型预后较差,将为今后制定乳腺癌个体化治疗提供重要依据。
Objective To investigate the status and prognosis of axillary lymph node metastasis in different molecular subtypes of breast cancer. Methods A total of 125 breast cancer patients who were admitted to our hospital from January 2005 to December 2007 were genotyped, and the status of axillary lymph node metastasis was analyzed. The prognosis was analyzed with follow-up results. Results Luminal A type 63 cases, 16 cases of lymph node metastasis, the transfer rate was 25.4%; 19 cases of Luminal B type, 7 cases of lymph node metastasis, the transfer rate was 36.8%; HER-2 overexpression in 26 cases, 11 cases of lymph node metastasis The rate was 42.3%; Basal-like type in 17 cases, 9 cases of lymph node metastasis, the transfer rate was 52.9%. The rate of Luminal A lymph node metastasis was significantly different from that of Basal-like (P <0.05), but there was no significant difference among the other types (P> 0.05). There was no significant difference in tumor size between the two subtypes using χ2 test (P> 0.05). After 2 to 5 years of follow-up, 8 patients had local recurrence or distant metastasis, including 2 cases of Luminal B, 5 cases of HER-2 overexpression and 1 case of Basal-like. Three of the eight patients died of liver metastases and the other five survived after treatment. Conclusion The molecular typing of breast cancer can be used as a predictor of axillary lymph node metastasis. The poor prognosis of HER-2 overexpression and Basal-like prognosis may provide an important basis for the future individualized treatment of breast cancer.