乳腺癌临床病理分类与临床病理特征研究

摘要

目的 探讨乳腺癌临床病理分类与患者临床病理特征的关系,并分析对于个体化治疗的价值.方法 以2011年1月至2012年12月间收治的浸润性乳腺癌患者为研究对象.依据201 1年St.Gallen共识提出的“临床病理分类”的方法,将乳腺癌分为Luminal A、Luminal B、人类表皮生长因子受体2(HER2)阳性和三阴型4个亚型,并采用x2检验和非参数检验进行统计学分析,探讨各亚型与TNM分期、病理组织分级的关系.结果 共530例患者人组,Luminal A型94例(17.7％),Luminal B型285例(53.8％),HER2阳性型59例(11.1％),三阴型92例(17.4％).Luminal B型中HER2阳性者56例(19.6％),HER2阴性者229例(80.4％).Luminal B型多数患者呈现病理组织学分级高(Ⅱ级以上占71.7％)以及TNM分期偏晚(Ⅱ期以上占66.7％)的情况.结论 临床病理分类是乳腺癌个体化治疗的重要参考依据,其中Luminal型占71.5％以上,应重视内分泌治疗的重要性;Luminal B型乳腺癌占53.8％,提高该亚型诊断标准的精确性,需要进一步开展深入研究.%Objective To explored the relationship of clinicopathological classification and clinical and pathological characteristics of breast cancer and analyze the value in treatment.Methods The patients with invasive breast carcinoma had been treated between January 2011 and December 2012.The breast cancer have been divided into luminal A,luminal B,HER2-positive and triple-negative subtypes according to criteria of St.Gallen International Expert Consensus report 2011.The Mann-Whitney test and KruskalWallis test were used to analyze the relationships between four subtypes and TNM staging,histopathological grading.Results The 530 cases of invasive breast cancer patients were included in this study.The luminal A was 94 cases (17.7％),the luminal B was of 285 cases (53.8％),the HER2-positive was 59 cases (11.1％),and the triple-negative subtype was 92 cases (17.4％).In luminal B subtype,the HER2-positive was 56 (19.6％) and negative was 229 (80.4％).Most of luminal B was later in grade (71.7％ of cases were more than Ⅱ grade) and stage (66.7％ were more than stage Ⅱ).Conclusions Clinical pathological classification is important in the individualized treatments of breast cancer,and the Luminal types (A + B) are more than 71.5％ of all breast cancer patients,and they should be paid more attention to the endocrine therapy ; Luminal B type accounted for 53.8％ of all breast cancer and it needs further study to improve the precision of the diagnosis and treatment.