乳腺癌原发灶与转移灶分子分型指标表达差异的研究

发布时间：2018-03-03 03:20

本文选题：乳腺癌　切入点：雌激素受体　出处：《中华肿瘤防治杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的乳腺癌患者激素受体(hormone receptor,HR)、人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)和增殖细胞核抗原Ki-67的表达状态直接影响治疗方案的制订。本研究通过比较可手术乳腺癌原发灶与腋窝淋巴结转移灶及治疗后远处转移灶之间HR、HER2和Ki-67表达状况,探讨其表达的一致性,以期为乳腺癌患者综合治疗方案的制订提供参考。方法选取2015-03-01-2016-04-30就诊于山东大学附属山东省肿瘤医院(162例)和梁山县人民医院(23例)的185例乳腺癌患者作为研究对象。患者均为女性,年龄24~79岁,中位年龄49岁。浸润性导管癌171例,浸润性小叶癌14例。初治直接接受手术治疗患者110例,其中有腋窝淋巴结转移77例;复发转移患者接受转移灶穿刺患者75例,其中肝脏转移43例,肺脏转移32例。所有标本均检测ER、PR、HER2和Ki-67表达,比较原发灶与腋窝淋巴结及远处转移灶的表达情况。结果原发灶与腋窝淋巴结转移灶ER、PR、HER2和Ki-67表达差异均无统计学意义(均P0.05),ER变化率为3.9%,PR为7.8%,HER2为11.7%,Ki-67为20.8%。原发灶与远处转移灶比较,PR和Ki-67表达差异有统计学意义(均P值0.05),而ER和HER2表达差异无统计学意义(均P0.05),ER变化率为21.3%,PR为29.3%,HER2为18.7%,Ki-67为29.3%。结论乳腺癌原发灶与转移腋窝淋巴结ER、PR、HER2和Ki-67表达状况一致性较高;原发灶与远处转移灶PR和Ki-67的表达存在差异,ER和HER2的表达无差异,这可能受多种因素的影响,建议对原发灶及转移灶同时进行生物学信息的检测,为患者制订治疗方案提供可靠的生物学信息。
[Abstract]:Objective: breast cancer patients with hormone receptor (hormone, receptor, HR), human epidermal growth factor receptor 2 (human epidermal growth factor receptor 2, HER2) and the expression of proliferating cell nuclear antigen Ki-67 directly affect the treatment plan. This study was to compare surgery in primary breast cancer and axillary lymph node metastasis distant metastasis between HR treatment of tumor and metastasis, the expression of HER2 and Ki-67, to explore the consistency of its expression, in order to provide reference for the formulation of comprehensive treatment programs for patients with breast cancer. Methods 2015-03-01-2016-04-30 in Shandong University Hospital Affiliated Tumor Hospital of Shandong province (162 cases) and Liangshan County People's Hospital (23 cases) in 185 cases of breast cancer patients as the object of study. The patients were female, aged 24~79 years old, the median age was 49 years. 171 cases of infiltrating ductal carcinoma, invasive lobular carcinoma in 14 cases. The initial treatment directly accept the surgical treatment in 110 cases, the There are 77 cases of axillary lymph node metastasis; recurrence and metastasis in patients with metastatic biopsy were 75 cases, 43 cases of liver metastasis, lung metastasis in 32 cases. All specimens were detected in ER, PR, HER2 expression and Ki-67 expression between the primary tumor and axillary lymph node and distant metastasis. The results of primary tumor and axillary lymph node metastasis ER, PR, HER2 and Ki-67 expression showed no significant difference (P0.05), the change rate of ER is 3.9%, PR is 7.8%, HER2 is 11.7%, Ki-67 is 20.8%. primary tumors and metastases, PR and Ki-67 expression was statistically significant (P value of 0.05), but no significant differences in the expression of HER2 and ER (P0.05), the change rate of ER was 21.3%, PR was 29.3%, HER2 was 18.7%, Ki-67 was 29.3%. conclusion in primary breast cancer and axillary lymph node metastasis of ER, PR, HER2 and Ki-67 expression in high consistency; the expression of primary tumor and metastasis the number of PR and Ki-67 exist difference There is no difference in the expression of ER and HER2, which may be influenced by many factors. It is suggested that simultaneous detection of biological information in primary and metastatic foci can provide reliable biological information for patients to develop therapeutic regimens.

【作者单位】：梁山县人民医院普外科;山东大学附属山东省肿瘤医院乳腺病中心山东省医学科学院;山东大学附属山东省肿瘤医院病理科山东省医学科学院;
【分类号】：R737.9

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