Risk Factors for Initial Lung Metastasis from Breast Invasive Ductal Carcinoma in Stages I-III of Operable Patients
Risk Factors for Initial Lung Metastasis from Breast Invasive Ductal Carcinoma in Stages I-III of Operable Patients
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DOI：
10.1093/jjco/hyn133
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发表时间：
2009-02-01
影响因子：
2.4
通讯作者：
Liu, Qi
中科院分区：
文献类型：
--
作者：
Gao, Dongwei;Du, Jiajun;Liu, Qi
本研究旨在评估可手术的I~III期浸润性导管癌患者初次肺转移的高危因素。回顾性分析2003年1月至2007年12月期间所有接受根治性乳房切除术并确诊为浸润性导管癌的患者的资料。记录纳入研究的患者的初诊、辅助方式和首次转移部位的常规临床检查资料。很容易从患者身上识别出可能的危险因素。调查了二十八个潜在风险因素。最终筛选出潜在因素数据完整的78例患者，并进行单因素和多因素分析。单因素分析显示，雌激素受体（ER）、孕激素受体（PR）状态以及表皮生长因子受体2（Her2）状态是浸润性导管乳腺癌以肺为第一器官转移的高危因素。 P值分别为0.045、0.049和0.026。多变量分析显示pN3分期需要结合血管侵犯来预测初始肺转移。 ER 和 PR 的状态也与 p53 阴性结合观察以预测肺转移。进一步分析表明，乳腺癌中四阴亚型与初次肺转移显着相关。pN3期和血管侵犯的患者更容易发生肺转移。 Her2 阴性的新亚型（ER 阴性和 PR 阴性与 p53 阴性组合）在乳腺浸润性导管癌患者中极有可能发生初始肺转移。
The aim of this study was to evaluate high-risk factors for initial lung metastases from breast invasive ductal carcinomas in operable patients with Stages I-III invasive ductal carcinoma.Data of all patients who underwent radical mastectomy were reviewed retrospectively, and they were confirmed with invasive ductal breast cancer between January 2003 and December 2007. Routine clinical examination data of patients included in the study at primary diagnosis, adjuvant modes and first metastasis sites were recorded. Possible risk factors were easily identified from patients. Twenty-eight potential risk factors were investigated. Finally, 78 patients with complete data in the potential factors were found eligible, and univariate and multivariate analyses were conducted.Univariate analyses showed that the status of estrogen receptor (ER) and progesterone receptor (PR) and the status of the epidermal growth factor receptor-2 (Her2) were high-risk factors for invasive ductal breast cancer metastasis to the lung as the first organ. P values were, respectively, 0.045, 0.049 and 0.026. Multivariate analyses showed that the pN3 stage needs to be combined with vascular invasion to predict initial lung metastasis. The status of ER and PR was also viewed in combination with p53 negative to predict lung metastasis. Further analyses demonstrated that a subtype of four negative in breast cancer was significantly associated with initial lung metastasis.Patients with pN3 stage and vascular invasion were more likely to develop lung metastasis. A new subtype with Her2 negative, both ER-negative and PR negative combination with p53 negative, had a great tendency to develop initial lung metastasis in breast invasive ductal cancer patients.