Clinicopathological factors predicting early and late distant recurrence in estrogen receptor-positive, HER2-negative breast cancer
Clinicopathological factors predicting early and late distant recurrence in estrogen receptor-positive, HER2-negative breast cancer
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DOI：
10.1007/s12282-015-0649-0
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发表时间：
2016-11-01
期刊：
影响因子：
4
通讯作者：
Tomioka, Nobumoto
中科院分区：
文献类型：
--
作者：
Yamashita, Hiroko;Ogiya, Akiko;Tomioka, Nobumoto
大多数分析晚期复发预后因素的研究都是在接受他莫昔芬或芳香化酶抑制剂作为雌激素受体（ER）阳性乳腺癌辅助内分泌治疗的绝经后妇女中进行的。（108例绝经前和115例绝经后）与早期远处复发和149例患者在2000年至2004年期间接受初始治疗的ER阳性、HER2阴性乳腺癌晚期远处复发患者（62例绝经前患者和87例绝经后患者）来自9家机构。对于每例晚期复发患者，选择约2例匹配的10年以上无复发的对照患者。根据绝经状态和年龄比较3组患者的临床病理因素和辅助治疗情况，绝经前妇女早期复发的预测因素为肿瘤大小大、淋巴结类型高和肿瘤分级高，而晚期复发的预测因素为肿瘤大小大和淋巴结类型高。在60岁以下绝经后妇女中，预测早期复发的因素是双侧乳腺癌、肿瘤大小大、淋巴结类别高、PgR表达低和Ki67标记指数（LI）高，而预测晚期复发的因素是肿瘤大小大和淋巴结类别高。另一方面，在60岁或以上的绝经后妇女中，预测早期复发的因素是双侧乳腺癌、肿瘤大小大、淋巴结类别高、肿瘤分级高、ER表达低和Ki67 LI高，而预测晚期复发的因素是淋巴结类别高，雌激素受体低表达和辅助内分泌治疗时间短。根据绝经状态和年龄，早期和晚期远处复发的预测因素可能不同。
Most studies analyzing prognostic factors for late relapse have been performed in postmenopausal women who received tamoxifen or aromatase inhibitors as adjuvant endocrine therapy for estrogen receptor (ER)-positive breast cancer.A total of 223 patients (108 premenopausal and 115 postmenopausal) with early distant recurrence and 149 patients (62 premenopausal and 87 postmenopausal) with late distant recurrence of ER-positive, HER2-negative breast cancer who were given their initial treatment between 2000 and 2004 were registered from nine institutions. For each late recurrence patient, approximately two matched control patients without relapse for more than 10 years were selected. Clinicopathological factors and adjuvant therapies were compared among the three groups by menopausal status and age.Factors predicting early recurrence in premenopausal women were large tumor size, high lymph node category and high tumor grade, whereas predictors for late recurrence were large tumor size and high lymph node category. In postmenopausal women under 60 years of age, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, low PgR expression and high Ki67 labeling index (LI), while predictors for late recurrence were large tumor size and high lymph node category. On the other hand, in postmenopausal women aged 60 years or older, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, high tumor grade, low ER expression and high Ki67 LI, whereas predictors for late recurrence were high lymph node category, low ER expression and short duration of adjuvant endocrine therapy.Predictors of early and late distant recurrence might differ according to menopausal status and age.