乳腺癌四个分子亚型与腋窝淋巴结转移的相关性研究

目的探讨乳腺癌四个分子亚型与腋窝淋巴结转移的相关性.方法选取乳腺癌患者264例,根据雌激素受体、孕激素受体、表皮生长因子受体2(Her-2)的表达,将其分为Luminal A型、Luminal B型、HER-2过表达型、Triple-negative型四个分子亚型,比较不同分子亚型之间腋窝淋巴结转移率的差异,并对影响腋窝淋巴结转移的相关因素进行多因素Logistic回归分析.结果 HER-2过表达型腋窝淋巴结转移率最高,其次为Luminal B型,不同分子亚型乳腺癌的腋窝淋巴结转移率之间差异具有统计学意义(P0.05).年龄和月经状态在腋窝淋巴结转移率之间差异无统计学意义(P0.05),浸润性小叶癌和导管癌较其他病理类型乳腺癌的淋巴结转移率明显增高;肿瘤直径大于5 cm后,淋巴结转移率明显增加,差异均具有显著统计学意义(P0.01).多因素回归分析显示:肿瘤大小、是否为Luminal A型、是否为浸润性导管癌、浸润性小叶癌为腋窝淋巴结转移的独立危险因素.结论 HER-2过表达型和Luminal B型乳腺癌腋窝淋巴结转移率较高;肿瘤大小、分子分型、病理类型为影响腋窝淋巴结转移的独立危险因素.

On Relationship between Four Subtypes of Breast Cancer Molecule and Axillary Lymph Node Metastasis

Objective To explore the relationship between molecular subtype and axillary lymph node metastasis in patients with breast cancer. Method 264 cases of breast cancer were divided into Luminal A type,Luminal B type, HER-2 over expression type, Triple-negative type, according to the expressions of estrogen receptor, progesterone receptor, epidermal growth factor receptor 2 ( Her-2 ) . The differences of axillary lymph node metastasis rate among four molecular subtypes were compared. And Logistic regression analysis of the multi-factor on the factors related to axillary lymph node metastasis was carried out. Results The HER-2 over expression type had the highest axillary lymph node metastasis rate followed by Luminal B type,and the difference among the four molecular subtypes were statistically significant ( P<0 . 05 ) . The rates of patients with different ages and menstrual status showed no statistical difference (P>0. 05). The metastasis rates of invasive lobular carcinoma and ductal carcinoma increased obviously than other pathological types. When the tumor diameter was larger than 5 cm,the rate of lymph node metastasis significantly increased (P<0. 01). Multiple regression analysis showed that,tumor size,whether Luminal A type or not,whether invasive lobular carcinoma and ductal carcinoma or not, were independent risk factors for axillary lymph node metastasis. Conclusion HER-2 over expression type and Luminal B type exhibited higher axillary lymph node metastasis rate in the patients with breast cancer. Molecular types,tumor size,pathological types were independent risk factors for the metastasis of axillary lymph node.