贵州省720例乳腺癌HER-2的表达情况及抗HER-2治疗的回顾性分析

发布时间：2018-04-15 10:12

本文选题：乳腺癌 + HER-表达　；参考：《中国癌症杂志》2017年11期

【摘要】：背景与目的:乳腺癌是严重威胁女性生命的恶性肿瘤之一,在我国汉族与其他少数民族乳腺癌的发病率及其HER-2基因表达差异成为学者关注的问题。该研究旨在分析贵州省乳腺癌HER-2基因表达的民族差异性,评价应用曲妥珠单抗行分子靶向治疗的临床疗效,探讨多种临床因素对贵州省乳腺癌患者生存预后的影响。方法:回顾性分析2007年1月—2013年12月在贵州医科大学附属肿瘤医院接受治疗的720例女性乳腺癌患者的随访情况,采用SPSS 17.0中的Kaplan-Meier法对患者进行生存分析,统计患者无病生存期(disease free survival,DFS)及总生存期(overall survival,OS),采用Log-rank检验进行因素间比较。采用Cox回归模式进行多因素检验,分析乳腺癌的独立预后因素。结果:入组的720例患者中,HER-2阴性表达520例(72.2%),HER-2阳性表达200例(27.8%)。200例HER-2阳性乳腺癌患者中,汉族177例(177/645,27.4%),少数民族23例(23/75,30.7%)。200例HER-2阳性乳腺癌患者中,行抗HER-2治疗37例(18.5%),未行抗HER-2治疗163例(81.5%),可分为治疗组及对照组。统计分析显示,治疗组与对照组的DFS和OS差异均有统计学意义(P=0.041和0.022)。Cox回归分析提示,雌激素受体(estrogen receptor,ER)和Ki-67是入组乳腺癌患者的独立预后因素(P=0.03和0.016),孕激素受体(progesterone receptor,PR和HER-2不是独立预后因素(P均0.05);其中汉族乳腺癌患者的ER和Ki-67是独立预后因素(P=0.018和0.031),PR和HER-2不是独立预后因素(P均0.05);少数民族乳腺癌患者的ER、PR、HER-2和Ki-67均不是独立的预后因素(P均0.05)。结论:HER-2基因阳性表达不具有民族差异性。HER-2阳性患者应用曲妥珠单抗行抗HER-2治疗可明显改善预后,延长DFS及OS,但目前贵州省行抗HER-2治疗人群不足20%。本研究初步提示ER、Ki-67作为乳腺癌独立的预后因素具有民族差异性的趋势。
[Abstract]:Background & objective: breast cancer is one of the malignant tumors that threaten the lives of women. The incidence of breast cancer and the difference of HER-2 gene expression between Han and other ethnic minorities in China have become a major concern.The purpose of this study was to analyze the national differences of HER-2 gene expression in breast cancer in Guizhou Province, to evaluate the clinical efficacy of molecular targeting therapy with tritozumab, and to explore the influence of various clinical factors on the survival and prognosis of breast cancer patients in Guizhou Province.Methods: the follow-up data of 720 female breast cancer patients who were treated in the Cancer Hospital of Guizhou Medical University from January 2007 to December 2013 were analyzed retrospectively. The survival of the patients was analyzed by Kaplan-Meier method in SPSS 17.0.The disease-free survival time (free) and total survival time (TFS) of the patients were analyzed and compared by Log-rank test.Cox regression model was used to analyze the independent prognostic factors of breast cancer.Results: of the 720 patients, 520 had negative expression of HER-2 and 200 had positive expression of HER-2. Of the 200 patients with HER-2 positive breast cancer, 177 cases of Han nationality had positive expression of HER-2, 177 cases of Han nationality had HER-2 positive breast cancer, and 23 cases of ethnic minorities had HER-2 positive breast cancer.37 cases were treated with anti HER-2, while 163 cases without anti HER-2 were divided into treatment group and control group.Statistical analysis showed that the difference of DFS and OS between the treatment group and the control group was statistically significant (P 0.041 and 0.022).Cox regression analysis).Estrogen receptor (ER) and Ki-67 are independent prognostic factors in breast cancer patients. Progesterone receptor PR and HER-2 are not independent prognostic factors, and ER and Ki-67 are independent prognostic factors in patients with breast cancer in Han nationality.Both ERP and HER-2 were not independent prognostic factors (P 0.05), and ERP PRH HER-2 and Ki-67 were not independent prognostic factors (P 0.05) in minority breast cancer patients.Conclusion there is no national difference in the positive expression of 1% HER-2 gene. Tratozumab can significantly improve the prognosis and prolong the prognosis of DFS and OS in patients with HER-2 positive. However, there are less than 20 cases in Guizhou province treated with anti-HER-2 at present.This study suggests that ERK-67 as an independent prognostic factor of breast cancer has a trend of ethnic differences.
【作者单位】：贵州医科大学附属肿瘤医院乳腺妇科肿瘤科;
【基金】：贵阳市科学技术局2015科技类计划项目(20151001)
【分类号】：R737.9

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