切换至 "中华医学电子期刊资源库"
高级检索
中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 21 -24. doi: 10.3877/cma.j.issn.1674-0793.2019.01.003

所属专题： 文献；

论著

Luminal B型乳腺癌骨转移患者的临床特点和预后分析
陈涛1, 司丕蕾1, 贾琳娇1, 韩智培1, 汪操1, 鲁鹤臻1, 蜜雪芳1, 李文涛1,†()   
  1. 1. 450003　郑州大学人民医院（河南省人民医院）乳腺外科
  • 收稿日期:2018-04-22 出版日期:2019-02-01
  • 通信作者: 李文涛
  • 基金资助:
    河南省医学科技攻关计划项目省部共建项目(201601013)

Clinical characteristics and prognosis of luminal B subtype breast cancer patients with bone metastasis

Tao Chen1, Pilei Si1, Linjiao Jia1, Zhipei Han1, Cao Wang1, Hezhen Lu1, Xuefang Mi1, Wentao Li1,†()   

  1. 1. Department ofBreast Surgery, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China
  • Received:2018-04-22 Published:2019-02-01
  • Corresponding author: Wentao Li
  • About author:
    Corresponding author: Li Wentao, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

陈涛, 司丕蕾, 贾琳娇, 韩智培, 汪操, 鲁鹤臻, 蜜雪芳, 李文涛. Luminal B型乳腺癌骨转移患者的临床特点和预后分析[J]. 中华普通外科学文献(电子版), 2019, 13(01): 21-24.

Tao Chen, Pilei Si, Linjiao Jia, Zhipei Han, Cao Wang, Hezhen Lu, Xuefang Mi, Wentao Li. Clinical characteristics and prognosis of luminal B subtype breast cancer patients with bone metastasis[J]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(01): 21-24.

目的

探讨luminal B型乳腺癌骨转移患者的临床特点和预后情况。

方法

收集2004年1月至2012年1月郑州大学人民医院诊治的luminal B型乳腺癌骨转移患者128例，其中75例人表皮生长因子受体（HER）-2阴性，53例HER-2阳性，回顾性分析其临床特点和预后。

结果

两组患者在骨转移确诊年龄、原发肿瘤大小、腋窝淋巴结转移数目和术后骨转移发生的时间方面的差异有统计学意义（χ2=4.477、6.927、12.209、11.222，P=0.034、0.023、0.002、0.004）。Luminal B型HER-2阴性乳腺癌患者发生骨转移后的中位生存时间为29.8个月，5年生存率22.7%，HER-2阳性乳腺癌患者分别为27.1个月和20.7%，两组患者骨转移后的生存时间差异无统计学意义（χ2=0.398，P=0.528）。

结论

Luminal B型HER-2阳性比luminal B型HER-2阴性乳腺癌骨转移患者更具有发病年龄大、原发肿瘤直径大、腋窝淋巴结转移数目多、术后发生骨转移时间早等特点，但两种类型患者的预后无显著差异。

关键词: 乳腺肿瘤, 分子分型, 预后, 骨转移, 临床特点
Objective

To investigate the clinical characteristics and prognosis of luminal B subtype breast cancer patients with bone metastases.

Methods

The data of one hundred and twenty-eight cases of luminal B subtype breast cancer with bone metastases were collected from January 2004 to January 2012, 75 of whom were HER-2 negative and 53 were HER-2 positive. The clinical characteristics and prognosis were analyzed retrospectively.

Results

There were statistically significant differences in the confirmed age of bone metastases, the size of the primary tumor, the number of axillary lymph node metastases, and the time of postoperative bone metastasis between the two groups (χ2=4.477, 6.927, 12.209, 11.222, P=0.034, 0.023, 0.002, 0.004). The median survival time and 5-year survival rate of luminal B HER-2 negative type breast cancer patients after bone metastases were 29.8 months and 22.7%, and 27.1 months and 20.7% respectively for luminal B HER-2 positive type breast cancer patients. There was no significant difference in survival time after bone metastasis between the two groups (χ2=0.398, P=0.528).

Conclusion

Luminal B HER-2 positive type is more common than luminal B HER-2 negative breast cancer patients with bone metastasis in older age, larger diameter of primary tumor, more axillary lymph node metastasis, and earlier bone metastasis after surgery. There is no significant difference in the prognosis of two type patients.

Key words: Breast neoplasms, Molecular typing, Progonosis, Bone metastases, Clinical characteristic
表1 128例luminal B型乳腺癌骨转移患者的病理特点[例(%)]
项目 A组 B组 χ2值 P值
例数 75 53
确诊年龄(岁) 4.477 0.034
≤45 16(21.3) 5(9.4)
>45 59(78.7) 48(90.6)
月经状态 0.869 0.351
绝经前 21(28.0) 11(20.8)
绝经后 54(72.0) 42(72.2)
原发肿瘤大小(cm) 6.927 0.023
≤2 29(38.7) 10(18.9)
>2~5 45(60.0) 40(75.5)
>5 1(1.3) 3(5.7)
淋巴结切除数目(枚) 0.029 0.986
≤10 16(21.3) 11(20.8)
>10~20 36(48.0) 25(47.2)
>20 23(30.7) 17(32.1)
淋巴结转移数目(枚) 12.290 0.002
0 30(40.0) 12(22.6)
1~3 35(46.7) 20(37.7)
>3 10(13.3) 21(39.6)
组织学分级 1.487 0.481
Ⅰ 9(12.0) 3(5.7)
Ⅱ 39(52.0) 31(58.5)
Ⅲ 27(36.0) 19(35.8)
脉管癌栓 0.029 0.846
阳性 28(37.3) 19(35.8)
阴性 47(62.7) 34(64.2)
肿瘤位置 0.021 0.886
左侧 42(56.0) 29(54.7)
右侧 33(44.0) 24(45.3)
病理类型 0.691 0.726
浸润性导管癌 66(88.0) 49(92.4)
浸润性小叶癌 6(8.0) 3(5.7)
其他 3(4.0) 1(1.9)
表2 128例luminal B型乳腺癌骨转移临床特点[例(%)]
临床特点 A组 B组 χ2值 P值
例数 75 53
是否单发 0.507 0.476
是 15(20.0) 8(15.1)
否 60(80.0) 45(84.9)
合并其他部位转移 1.977 0.160
是 51(68.0) 42(79.2)
否 24(32.0) 11(20.8)
骨相关事件 0.134 0.714
是 35(46.7) 23(43.4)
否 40(53.3) 30(56.6)
治疗方式
化疗 0.179 0.672
是 63(84.0) 43(81.1)
否 12(16.0) 10(18.9)
靶向治疗 / /
是 - 21(39.6)
否 - 32(60.4)
双磷酸盐 1.022 0.312
是 56(74.7) 44(83.0)
否 19(25.3) 9(17.0)
骨转移术后发生时间(年) 11.222 0.004
≤2 12(16.0) 22(41.5)
>2~5 43(57.3) 18(34.0)
>5 20(26.7) 13(24.5)
图1 HER-2阴性和HER-2阳性乳腺癌骨转移患者的生存曲线
[1]
Lorusso G, Rüegg C. New insights into the mechanisms of organ-specific breast cancer metastasis[J]. Semin Cancer Biol, 2012, 22(3): 226-233.
[2]
Weilbaecher KN, Guise TA, McCauley LK. Cancer to bone: a fatal attraction[J]. Nat Rev Cancer, 2011, 11(6): 411-425.
[3]
Huber KE, Carey LA, Wazer DE. Breast cancer molecular subtypes in patients with locally advanced disease: impact on prognosis, patterns of recurrence, and response to therapy[J]. Semin Radiat Oncol, 2009, 19(4): 204-210.
[4]
Metzger-Filho O, Sun Z, Viale G, et al. Patterns of recurrence and outcome according to breast cancer subtypes in lymph node–negative disease: results from international breast cancer study group trials Ⅷ and Ⅸ[J]. J Clin Oncol, 2013, 31(25): 3083-3090.
[5]
Winczura P, Sosińskamielcarek K, Duchnowska R, et al. Immunohistochemical predictors of bone metastases in breast cancer patients[J]. Pathol Oncol Res, 2015, 21(4): 1229-1236.
[6]
Kuchuk I, Hutton B, Moretto P, et al. Incidence, consequences and treatment of bone metastases in breast cancer patients-experience from a single cancer centre[J]. J Bone Oncol, 2013, 2(4): 137-144.
[7]
Ahn SG, Lee HM, Cho SH, et al. Prognostic factors for patients with bone-only metastasis in breast cancer[J]. J Bone Oncol, 2013, 54(5): 1168-1177.
[8]
Dawood S, Hu R, Homes MD, et al. Defining breast cancer prognosis based on molecular phenotypes: results from a large cohort study[J]. Breast Cancer Res Treat, 2011, 126(1): 185-192.
[9]
Pogoda K, Niwińska A, Murawska M, et al. Analysis of pattern, time and risk factors influencing recurrence in triple-negative breast cancer patients[J]. Med Oncol, 2013, 30(1): 388-396.
[10]
Diessner J, Diessner M, Stüber T, et al. Evaluation of clinical parameters influencing the development of bone metastasis in breast cancer[J]. BMC Cancer, 2016, 16(1): 307.
[11]
Cleeland C, Moos RV, Walker MS, et al. Burden of symptoms associated with development of metastatic bone disease in patients with breast cancer[J]. Support Care Cancer, 2016, 24(8): 3557-3565.
[12]
唐玲. 乳腺癌骨转移与其临床病理因素的相关性分析[D]. 沈阳：辽宁中医药大学, 2016.
[13]
Irelli A, Cocciolone V, Cannita K, et al. Bone targeted therapy for preventing skeletal-related events in metastatic breast cancer[J]. Bone, 2016, 87(1): 169-175.
[14]
Patrick DL, Cleeland CS, Von MR, et al. Pain outcomes in patients with bone metastases from advanced cancer: assessment and management with bone-targeting agents[J]. Support Care Cancer, 2015, 23(4): 1157-1168.
[15]
Jensen AØ, Jacobsen JB, Nørgaard M, et al. Incidence of bone metastases and skeletal-related events in breast cancer patients: a population-based cohort study in Denmark[J]. BMC Cancer, 2011, 11(1): 29-35.
[16]
Hagiwara M, Delea TE, Chung K. Healthcare costs associated with skeletal-related events in breast cancer patients with bone metastases[J]. J Med Econ, 2014, 17(3): 223-230.
[17]
Luo A, Wu F, Han R, et al. Clinicopathological features and prognostic evaluation of bone metastasis in triple-negative breast cancer[J]. J Cancer Res Ther, 2017, 13(5): 778-784.
[1] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 844-848.
[2] 应康, 杨璨莹, 刘凤珍, 陈丽丽, 刘燕娜. 左心室心肌应变对无症状重度主动脉瓣狭窄患者的预后评估价值[J]. 中华医学超声杂志（电子版）, 2023, 20(06): 581-587.
[3] 张思平, 刘伟, 马鹏程. 全膝关节置换术后下肢轻度内翻对线对疗效的影响[J]. 中华关节外科杂志(电子版), 2023, 17(06): 808-817.
[4] 马伟强, 马斌林, 吴中语, 张莹. microRNA在三阴性乳腺癌进展中发挥的作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 111-114.
[5] 杨倩, 李翠芳, 张婉秋. 原发性肝癌自发性破裂出血急诊TACE术后的近远期预后及影响因素分析[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 33-36.
[6] 栗艳松, 冯会敏, 刘明超, 刘泽鹏, 姜秋霞. STIP1在三阴性乳腺癌组织中的表达及临床意义研究[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 52-56.
[7] 江振剑, 蒋明, 黄大莉. TK1、Ki67蛋白在分化型甲状腺癌组织中的表达及预后价值研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 623-626.
[8] 晏晴艳, 雍晓梅, 罗洪, 杜敏. 成都地区老年转移性乳腺癌的预后及生存因素研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 636-638.
[9] 李智铭, 郭晨明, 庄晓晨, 候雪琴, 高军喜. 早期乳腺癌超声造影定性及定量指标的对比研究[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 639-643.
[10] 鲁鑫, 许佳怡, 刘洋, 杨琴, 鞠雯雯, 徐缨龙. 早期LC术与PTCD续贯LC术治疗急性胆囊炎对患者肝功能及预后的影响比较[J]. 中华普外科手术学杂志(电子版), 2023, 17(06): 648-650.
[11] 潘冰, 吕少诚, 赵昕, 李立新, 郎韧, 贺强. 淋巴结清扫数目对远端胆管癌胰十二指肠切除手术疗效的影响[J]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 608-612.
[12] 卢艳军, 马健, 白鹏宇, 郭凌宏, 刘海义, 江波, 白文启, 张毅勋. 纳米碳在腹腔镜直肠癌根治术中253组淋巴结清扫的临床效果[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 473-477.
[13] 李永胜, 孙家和, 郭书伟, 卢义康, 刘洪洲. 高龄结直肠癌患者根治术后短期并发症及其影响因素[J]. 中华临床医师杂志(电子版), 2023, 17(9): 962-967.
[14] 王军, 刘鲲鹏, 姚兰, 张华, 魏越, 索利斌, 陈骏, 苗成利, 罗成华. 腹膜后肿瘤切除术中大量输血患者的麻醉管理特点与分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 844-849.
[15] 索利斌, 刘鲲鹏, 姚兰, 张华, 魏越, 王军, 陈骏, 苗成利, 罗成华. 原发性腹膜后副神经节瘤切除术麻醉管理的特点和分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 771-776.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号