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目的:分析不同分子分型乳腺癌与预后的差异,为临床工作提供一定的分子依据。方法:通过免疫组织化学法检测雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(Her-2)、细胞角蛋白5/6(CK5/6)、表皮生长因子受体(EGFR)和ki67的表达,运用组织芯片回顾性分析310例于2001年1月至2014年7月就诊于上海某医院乳腺浸润性导管癌患者的临床病理资料,将其分为Luminal A型、Luminal B型、Her-2过表达型、Basal-like型、Normal breast-like型5种类型,分析各分子分型乳腺癌的预后,并筛选分析预后相关因素。结果:310例乳腺癌患者所占比例分别为Luminal A型43.87%、Luminal B型24.19%、Her-2过表达型11.61%、Basal-like型17.10%、Normal breast-like型11.94%。随访过程时间为2-162个月,中位时间为103个月,发生终点事件的患者91例。卡方检验示不同分子分型间患者年龄分布、肿瘤大小及位置、是否有淋巴结转移没有差异(P>0.05),而乳腺癌病理分级、是否有CK5/6、EGFR以及肿瘤抑制基因53(TP53)则存在组间差异(P<0.05)。不同分子分型乳腺癌中Luminal A型乳腺癌的生存率最高,其余依次是Luminal B型、Her-2过表达型与Basal-like型、Normal breast-like型。结论:不同分子分型乳腺癌预后存在差异性,Luminal A型乳腺癌预后最好,Basal-like型和normal breast like型和HER-2阳型乳腺癌预后最差。
Objective: To analyze the difference of prognosis between breast cancer of different molecular types and to provide some molecular basis for clinical work. Methods: Immunohistochemical method was used to detect the expression of ER, PR, Her-2, CK5 / 6, epidermis Using tissue microarray to analyze the clinicopathological data of 310 patients with invasive ductal carcinoma of the breast in a hospital in Shanghai from January 2001 to July 2014, the patients were divided into Luminal A type, Luminal B type, Her-2 overexpression, Basal-like type and Normal breast-like type. The prognosis of each molecular breast cancer was analyzed and the prognostic factors were screened. Results: The proportion of 310 breast cancer patients was 43.87% for Luminal A, 24.19% for Luminal B, 11.61% for Her-2 overexpression, 17.10% for Basal-like and 11.94% for Normal breast-like. The duration of follow-up was 2-162 months with a median time of 103 months and 91 patients had an end point event. Chi-square test showed age distribution, tumor size and location, lymph node metastasis (P> 0.05), and histological grade of breast cancer, CK5 / 6, EGFR and tumor suppressor gene 53 ) There was a difference between groups (P <0.05). Luminal A breast cancer has the highest survival rates in different molecular breast cancer types, followed by Luminal B, Her-2 and Basal-like, and Normal breast-like. Conclusion: The prognosis of breast cancer with different molecular types is different, Luminal A breast cancer has the best prognosis, Basal-like and normal breast like and HER-2 positive breast cancer have the worst prognosis.