Molecular subtype predicts incidence and prognosis of brain metastasis from breast cancer in SEER database
Molecular subtype predicts incidence and prognosis of brain metastasis from breast cancer in SEER database
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DOI：
10.1007/s00432-018-2697-2
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发表时间：
2018-09-01
影响因子：
3.6
通讯作者：
Kim, In Ah
中科院分区：
文献类型：
--
作者：
Kim, Yi-Jun;Kim, Jae-Sung;Kim, In Ah
目的 评价分子亚型对乳腺癌脑转移发生率和预后的影响。方法采用监测、流行病学和最终结果（SEER）18登记系统选取2010年至2014年乳腺癌患者。分子亚型分为luminal A（激素受体[HR]F/人表皮生长因子受体2[HER2]-）、luminal B (HR+/HER2+)、HER2 (HR-/HER2+) 或三阴性乳腺癌 (TNBC) (HR-I HER2-)。根据分子亚型评估脑转移的发生率和预后。结果在206913例乳腺癌患者中，HER2亚型的脑转移发生率最高（1.0%）。具有多个颅外转移（骨、肝和肺）的 HER2 和 TNBC 脑转移发生率较高（分别为 28.0% 和 30.8%）。脑转移中管腔 A、管腔 B、HER2 和 TNBC 的中位生存期分别为 12、23、10 和 6 个月 (p < 0.001)，无内脏转移的脑转移中为 14、34、17 和 8 个月 (p < 0.001)。多因素分析显示，所有脑转移患者预后良好的亚型顺序为luminal B、luminal A、HER2、TNBC，而无内脏转移的脑转移患者，预后良好的顺序为luminal B、HER2、luminal A、TNBC。结论脑转移患者预后预测应考虑分子亚型和内脏转移。对于有内脏转移的 HER2 和 TNBC 癌症亚型患者，密切监测可能有助于早期发现脑转移，并可能改善生活质量和生存率。
Purpose To evaluate the impact of molecular subtype on incidence and prognosis of brain metastasis from breast cancer.Methods The Surveillance, Epidemiology, and End Results (SEER) 18 registry was used to select breast cancer patients from 2010 to 2014. Molecular subtypes were classified as luminal A (hormone receptor [HR]F/human epidermal growth factor receptor 2 [HER2]-), luminal B (HR+/HER2+), HER2 (HR-/HER2+), or triple negative breast cancer (TNBC) (HR-I HER2-). The incidence and prognosis of brain metastasis was evaluated according to molecular subtype.Results Among the 206913 breast cancer patients, the HER2 subtype showed the highest incidence of brain metastasis (1.0%). HER2 and TNBC with multiple extracranial metastases (bone, liver, and lung) showed a high incidence of brain metastasis (28.0 and 30.8%, respectively). Median survival of luminal A, luminal B, HER2, and TNBC in brain metastasis was 12, 23, 10, and 6 months (p < 0.001), and in brain metastasis without visceral metastasis was 14, 34, 17, and 8 months (p < 0.001). On multivariate analysis, the order of subtype by favorable prognosis was luminal B, luminal A, HER2, and TNBC in all brain metastasis, while for brain metastasis patients without visceral metastasis, the order was luminal B, HER2, luminal A, and TNBC.Conclusions Molecular subtype and visceral metastasis should be considered for prediction of prognosis for patients with brain metastasis. The patients with HER2 and TNBC cancer subtypes having visceral metastasis, close surveillance could contribute to early detection of brain metastasis and may putatively lead to improved quality of life and survival.