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目的:探讨乳腺浸润性导管癌不同分子亚型与其腋窝淋巴结转移的关系。方法:根据乳腺癌分子分型标准,将243例原发乳腺浸润性导管癌的手术患者分为Luminal A型、Luminal B型[又分为HER-2(-)和HER-2(+)]、HER-2过表达型和三阴型。结合临床病理资料,分析各分子亚型的分布特点,以及与腋窝淋巴结转移的关系。结果:243例患者中,Luminal B[HER-2(-)]型最多(78例,32.1%),其次是Luminal A型(58例,23.87%),随后为三阴型(41例,16.87%)、HER-2过表达型(34例,13.99%)、Luminal B[HER-2(+)]型(32例,13.17%);94例(38.68%)发生腋窝淋巴结转移,各分子亚型患者腋窝淋巴结转移发生率差异有统计学意义(P<0.05),其中Luminal B[HER-2(-)]型(42例,53.85%)和Luminal B[HER-2(+)]型(15例,46.88%)中发生率最高,且两者间差异无统计学意义(P>0.05),其后依次为Luminal A型(19例,32.76%),三阴型(12例,29.27%),HER-2过表达型(6例,17.65%);各分子亚型分布在累及1~3枚及≥4枚淋巴结转移的分组中,差异均无统计学意义(均P>0.05),但前者Luminal B[HER-2(+)]型最多,HER-2过表达型最少,而后者HER-2过表达型最多,Luminal B[HER-2(+)]型最少。结论:乳腺浸润性导管癌的分子分型对评估腋窝淋巴结转移状况、判断疾病状态有一定参考价值,可成为制定个体化诊治策略的依据。
Objective: To investigate the relationship between different subtypes of breast invasive ductal carcinoma and axillary lymph node metastasis. Methods: According to the molecular classification criteria of breast cancer, 243 patients with primary breast invasive ductal carcinoma were divided into Luminal A type, Luminal B type [divided into HER-2 (-) and HER-2 , HER-2 overexpression and triple negative. Combined with clinicopathological data, the distribution characteristics of each subtype and the relationship with axillary lymph node metastasis were analyzed. RESULTS: Of the 243 patients, Luminal B [HER-2 (-)] had the highest number (78, 32.1%) followed by Luminal A (58, 23.87% HER-2 overexpression (34 cases, 13.99%), Luminal B [HER-2 (+)] type in 32 cases (13.17%); axillary lymph node metastasis in 94 cases (38.68% The incidence of axillary lymph node metastasis was significantly different between the two groups (P <0.05), of which Luminal B [HER-2 (-)] type was 42 (53.85%) and Luminal B [HER-2 15 cases, 46.88%), and there was no significant difference between them (P> 0.05), followed by Luminal A type (19 cases, 32.76%) and triple negative type (12 cases, 29.27% ), HER-2 overexpression (6 cases, 17.65%). There was no significant difference in the distribution of subtypes among the groups of 1 to 3 and ≥4 lymph node metastasis (all P> 0.05) However, the former Luminal B [HER-2 (+)] type had the most, the HER-2 overexpression was the least, while the latter had the most HER-2 overexpression and the Luminal B [HER-2 (+)] was the least. Conclusion: The molecular classification of invasive ductal carcinoma of the breast has some reference value for assessing the status of axillary lymph node metastasis and judging the disease status, which may be the basis for formulating individual diagnosis and treatment strategies.