Prognostic significance of molecular subtype in T1N0M0 breast cancer: Korean experience
Prognostic significance of molecular subtype in T1N0M0 breast cancer: Korean experience
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DOI：
10.1016/j.ejso.2011.04.014
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发表时间：
2011-07-01
期刊：
影响因子：
3.8
通讯作者：
Noh, W. C.
中科院分区：
文献类型：
--
作者：
Kim, R. G.;Kim, E. K.;Noh, W. C.
Put-pose：基因表达谱研究已经确定了与显著不同的临床结果相关的几种乳腺癌亚型。一般来说，I期乳腺癌患者的预后良好。我们根据分子亚型评估了T1 N 0 M0乳腺癌患者的临床病理特征和结局。方法：对1990年1月至2007年12月期间接受根治性手术的762例T1 N 0 M0乳腺癌患者进行分析。根据激素受体（HR）和人表皮生长因子受体-2（HER 2）状态将亚型分类如下：HR+/HER 2-、HR+/HER 2+、HR-/HER 2-（三阴性，TN）和HR-/HER 2+。结果：各亚型的分布依次为HR+/HER 2-（56.6%）、HR+/HER 2+（10.1%）、TN（20.1%）和HR+/HER 2+（13.3%）。观察到显著差异：在多灶性/多中心性、组织学分级、广泛导管内成分、p53表达和Ki-67指数等亚型之间。不同分子亚型患者的无复发生存期和总生存期存在差异（对数秩p分别< 0.001和0.024）。通过多变量分析，淋巴管浸润和分子亚型分类是复发的独立预测因子（分别为p = 0.003和0.043）。与HR+/HER 2-亚型相比，TN亚型的无复发生存率显著更差（风险比，4.54; 95%置信区间，1.60-12.86; p = 0.004）。结论：T1 N 0 M0乳腺癌患者，一组具有普遍良好的临床结果，具有与分子亚型相关的肿瘤。TN亚型是T1 N 0 M0乳腺癌患者复发的独立预测因子。(C)2011爱思唯尔有限公司保留所有权利。
Put-pose: Gene expression profiling studies have identified several breast cancer subtypes associated with markedly different clinical outcomes. In general, patients with stage I breast cancer have excellent outcomes. We assessed the clinicopathological characteristics and outcomes of patients with T1N0M0 breast cancer according to molecular subtype. Methods: Seven hundred and sixty-two T1N0M0 breast cancer patients undergoing curative surgery between January 1990 and December 2007 were analyzed. Subtypes were classified according to hormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) status as follows: HR+/HER2-, HR+/HER2+, HR-/HER2- (triple-negative, TN), and HR-/HER2+. Results: The distribution of subtypes was HR+/HER2-, 56.6%; HR+/HER2+, 10.1%; TN, 20.1%; and HR+/HER2+, 13.3%. Marked differences were observed: among subtypes in multifocality/multicentricity, histological grade, extensive intraductal components, p53 expression and the Ki-67 index. There were differences in recurrence-free survival and overall survival among patients with different molecular subtypes (log-rank p < 0.001 and 0.024, respectively). By multivariate analysis, lymphovascular invasion and classification of molecular subtype were independent predictors of recurrence (p = 0.003 and 0.043, respectively). The TN subtype showed significantly worse recurrence-free survival compared to the HR+/HER2- subtype (hazard ratio, 4.54; 95% confidence interval, 1.60-12.86; p = 0.004). Conclusion: Patients with T1N0M0 breast cancer, a group with generally favorable clinical outcomes, had prognoses that were associated with the molecular subtype. The TN subtype was an independent predictor for recurrence in patients with T1N0M0 breast cancer. (C) 2011 Elsevier Ltd. All rights reserved.