摘要：目的：探讨乳腺癌患者早期骨和内脏转移的临床特点及其与肿瘤学标记的相关性。方法：采用回顾性对照研究方法。收集2008年1月至2014年1月皖南医学院附属弋矶山医院收治的乳腺癌患者共384例。乳腺癌早期转移定义为从病理诊断为乳腺癌开始计算到发生远处转移的时间小于24个月。发生肝脏转移、肺转移、脑转移、胸膜转移的患者归类为内脏转移组。仅发生骨骼转移的患者归类为骨转移组。同时发生骨和内脏转移的患者归为骨和内脏同时转移组。分别比较骨转移组、内脏转移组、骨和内脏同时转移组与无转移组的临床特点及其肿瘤学标记的差异。结果：384例患者中有95例（24.7％）发生骨转移，64例（16.7％）发生内脏转移，58例（15.1％）发生骨和内脏同时转移，167例（43.5％）无转移。乳腺癌早期骨和内脏转移与年龄、绝经状态、原发肿瘤大小、淋巴结转移、脉管癌栓、ER状态、PR状态、HER-2表达、肿瘤分子分型有关（ P均＜0.05），而与病理类型、组织学分级无明显相关性（ P均＞0.05）。95例骨转移患者中有44例（46.3％）为TNBC。64例内脏转移患者中有27例（42.2％）为TNBC。58例骨和内脏同时转移患者中有21例（36.2％）为TNBC。结论：我们的研究初步表明，乳腺癌早期骨和内脏转移与年龄、绝经状态、原发肿瘤大小、淋巴结转移、脉管癌栓、ER状态、PR状态、HER-2表达、肿瘤分子分型有关，三阴性乳腺癌具有较强的早期转移能力。%Objective:To investigate the clinical properties of early bone and visceral metastases in patients with breast cancer and the relation with tumor predictors.Methods:A controlled-retrospective study was performed in 384 patients with breast cancer admitted to the First Affiliated Hospital of Wannan Medical College from January 2008 through 2014.Early metastases was defined as less than 24 months,i.e,from the initial diagnosis by pathology confir-mation to distant metastasis.The visceral metastasis group included liver,lung,brain or pleura involvement,and the bone metastasis group,the bone in-volmvent.The metastases involved in both vercera and bone were defined as coinstantaneous group .The clinical properties and tumor predictors were com-pared among the previous groups with metastases and non-metastasis.Results:Of the 384 patients,bone metastases occurred in 95(24.7%),visceral me-tastases in 64(16.7%) and coinstantaneous metastases in 58(15.1%).167 patients had no distant metastases(43.5%).Early metastases of bones and viscera were associated with ages,menopausal status,tumor size,lymph node involvement,lymphovascular invasion,estrogen receptor(ER),progesterone receptor(PR) and HER-2eu pattern(all P<0.05),whereas had no significant relation with pathological type and histological grading(all P<0.05). In 95 patients with bone metastases,44 were associated with triple negative breast cancer(TNBC,46.3%),and 64 with visceral metastases,27 were TNBC (42.2%).Of the 58 with coinstantaneous metastases,21 were TNBC(36.2%).Conclusion:Our findings suggest that early metastases of bones and vis-cera are involved in ages,menopausal status,tumor size,lymph node involvement,lymphovascular invasion,ER,PR and HER-2eu pattern as well as mo-lecular classification,and the metastasis mostly occurs in aggressive TNBC.
