Distribution, clinicopathologic features and survival of breast cancer subtypes in Southern China.
Distribution, clinicopathologic features and survival of breast cancer subtypes in Southern China.
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DOI：
10.1111/j.1349-7006.2012.02339.x
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发表时间：
2012-09
期刊：
影响因子：
5.7
通讯作者：
Yuan Z
中科院分区：
文献类型：
--
作者：
Xue C;Wang X;Peng R;Shi Y;Qin T;Liu D;Teng X;Wang S;Zhang L;Yuan Z
按不同亚型进行乳腺癌研究和治疗是一种必然趋势。我们调查了中国南方不同乳腺癌亚型的临床病理特征和预后。共确定了5809例浸润性导管癌患者。使用雌激素受体（ER）、孕激素受体（PR）、人表皮生长因子受体2（Her2/neu）和Ki - 67增殖指数的免疫组化（IHC）标志物将病例分为五种分子亚型。回顾性分析了临床病理特征和生存率。在所有患者中，31.1%为腔面A型，30.4%为腔面B型（高Ki - 67），13.1%为腔面B型（Her2/neu +），9.0%为Her2/neu型，16.5%为三阴性型。腔面B型（高Ki - 67）主要出现在绝经前患者中，平均年龄最低（43.0岁）。Her2/neu阳性肿瘤与侵袭性特征更为密切相关，包括肿瘤增大、淋巴结阳性和淋巴管浸润（LVI）。三阴性型的特点是组织学分级较差。Her2/neu阳性病例的5年无病生存率（DFS）和总生存率（OS）最差。对OS和DFS的多因素分析表明，五种亚型存在不同的不良预后因素。对于腔面A型和三阴性型患者，环磷酰胺、甲氨蝶呤和5 - 氟尿嘧啶（5FU）（CMF）方案的疗效与蒽环类和紫杉类方案相当，但对于两种腔面B型和Her2/neu型患者，其疗效不如蒽环类和紫杉类方案。传统标志物的预后意义在不同亚型之间可能存在差异。本研究揭示了不同乳腺癌亚型之间独特的临床病理特征、全身治疗获益、预后因素和生存率。
Breast cancer research and treatment by different subtypes is an inevitable trend. We investigated the clinicopathologic features and outcomes of different breast cancer subtypes in Southern China. A total of 5809 patients with invasive ductal carcinomas were identified. Immunohistochemical (IHC) markers for estrogen receptor (ER), progesterone receptor (PR), Her2/neu, and Ki-67 proliferation index were used to classify cases into five molecular subtypes. Clinicopathologic characteristics and survival rates were analyzed retrospectively. Of all patients, 31.1% were luminal A subtype, 30.4% luminal B (high Ki-67), 13.1% luminal B (Her2/neu+), 9.0% Her2/neu and 16.5% triple negative subtype. Luminal B (high Ki-67) presented primarily in premenopausal patients with the lowest average age (43.0 years). Her2/neu positive tumors were more closely associated with aggressive features including increased tumor size, positive lymph node status and lymphvascular invasion (LVI). Triple negative subtype was characterized by poorer histologic grade. Her2/neu positive cases had presented the worst 5-year disease-free survival (DFS) and overall survival (OS). Multivariate analyses of OS and DFS suggested that there were different negative prognostic factors for the five subtypes. The benefit of the cyclophosphamide, methotrexate, and 5-fluorouracil (5FU) (CMF) regimen was equal to that of anthracycline-based and Taxane-based regimens for patients with luminal A subtype and triple negative subtype, but inferior to anthracycline-based and Taxane-based regimens for those with two luminal B subtypes and Her2/neu subtype. The prognostic significance of traditional markers may differ among subtypes. This study revealed the distinct clinicopathologic characteristics, systemic therapy benefits, prognostic factors and survival rate among different breast cancer subtypes.
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影响因子：
45.3
作者：
Gonzalez-Angulo, Ana M.;Litton, Jennifer K.;Hortobagyi, Gabriel N.
通讯作者：
Hortobagyi, Gabriel N.
影响因子：
3.8
作者：
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45.3
作者：
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通讯作者：
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45.3
作者：
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通讯作者：
De Placido, Sabino
影响因子：
2.1
作者：
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通讯作者：
Caggiano, Vincent