目的 探讨雌激素受体(ER)阳性、淋巴结阴性、人表皮生长因子受体(HER)2阴性的早期乳腺癌患者21基因复发评分(RS)与临床病理特征的关系,及其在治疗方案制订中的作用.方法 收集120例早期乳腺癌患者肿瘤组织标本,利用分支DNA液相芯片技术检测21基因RS及 TUBB3、TYMS、TOP2A mRNA表达水平,比较不同风险分级患者的临床病理特征,并根据RS及TUBB3、TYMS、TOP2A mRNA表达水平制订治疗方案.结果 乳腺癌RS风险评分,低风险组(RS<18分)为61.7%;中风险组(RS为18~ <31分)为26.7%,高风险组(RS≥31分)为11.7%.RS风险分组例数在不同组织分级、孕激素受体(PR)状态、Ki67状态上差异均有统计学意义(P<0.05).根据RS分组,51.6% 的患者治疗决策发生改变,其中48.3% 的患者免于化疗.中位随访时间为22个月,3位患者出现局部复发,未出现远处复发.结论 21基因RS与早期乳腺癌组织分级、PR表达、Ki67表达有关,RS有助于治疗决策制订,降低患者化疗率.%Objective To investigate the correlation between 21-gene Recurrence Score(RS)and clinic pathological features and the effect of RS on treatment programme making in the early breast cancer patients with estrogen receptor(ER)positive,lymph node negative and human epidermal grow th factor receptor (HER)2 negative.Methods The expression levels of TUBB3,TYMS,TOP2A and 21 genes in 120 cases of breast cancer tissue detected by branch-DNA liquid chip technology.The relationship between the expression of the above 21-gene RS and the clinical and pathological characteristics of breast cancer were analyzed.Devel-op treatment protocols based on the RS score and mRNA expression.Results Among the 120 patients,61.7%had a low RS that less than 18 scores,26.7% had an intermediate RS that from 18 to less than 31 scores,and 11.7% had a high RS that equal or more than 31 scores.Cases with RS stases on different characteristics of histological grade,progesterone receptor(PR)and Ki-67 were statistically different(P<0.05).Treatment de-cisions were changed in 51.6% patients in 120 patients.48.3% patients avoided chemotherapy.The median follow-up time was 22 months.Only 3 cases had recurrence.No distal metastasis was reported.Conclusion The 21-gene RS is closely related to the histological grade,PR and Ki-67,RS reduces chemotherapy use in ear-ly breast cancer patients.
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