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2016年6月23日，《中华肿瘤杂志》发表中国医学科学院肿瘤医院的研究报告，比较了HER2阴性、雌激素受体（ER）阳性乳腺癌近期与远期复发患者的临床病理特征和预后。 该研究收集了2003～2009年中国医学科学院肿瘤医院收治的手术后复发转移的乳腺癌患者资料，筛选出符合入组条件的HER2阴性、ER阳性乳腺癌390例（其中近期复发279例，远期复发111例），比较了近期与远期复发患者的临床病理特征、首发转移部位及复发后生存情况的差异。 结果发现，合并脉管瘤栓、淋巴结转移≥4个的患者在近期复发组中所占的比例更高（均P＜0.05），而激素受体双阳性者和内分泌治疗不规范者在远期复发组中更常见（均P＜0.05）。在远期复发组患者中，首发肺转移达47.7%，明显高于近期复发组患者（25.1%，P＜0.001）。尽管在远期复发组患者中，首发内脏转移和多器官转移更常见（均P＜0.05），但远期复发组患者的复发后中位生存时间为66个月，明显长于近期复发组患者（39个月，P＝0.003）。 因此，近期复发和远期复发的HER2阴性、ER阳性乳腺癌患者在临床病理特征和预后方面均存在差异，合并脉管瘤栓、淋巴结转移≥4个是影响HER2阴性、ER阳性乳腺癌患者无病生存的重要因素，且更多表现为近期复发。远期复发是HER2阴性ER阳性乳腺癌较为普遍的复发模式，特别是激素受体双阳性和内分泌治疗不规范者更容易出现远期复发。远期复发组患者的预后优于近期复发组患者。 Zhonghua Zhong Liu Za Zhi. 2016 Jun 23;38(6):448-53. Clinicopathological features and prognosis of HER2-negative luminal-type breast cancer patients with early and late recurrence. Chen XL, Fan Y, Xu BH. Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. OBJECTIVE: To compare the clinicopathological features and prognosis of HER2-negative luminal-type breast cancer patients with early and late recurrence. METHODS: We reviewed the records of recurrent breast cancer patients who previously underwent surgery at the Cancer Hospital, Chinese Academy of Medical Sciences between 2003 and 2009. A total of 390 cases were identified as eligible recurrent patients with HER2-negative luminal-type breast cancer. Among them, 279 cases had early recurrence (DFS<5 years) and 111 cases had late recurrence (DFS≥5 years). The clinicopathological features, sites of initial metastasis and survival after recurrence in the two groups were compared and analyzed. RESULTS: Patients with vascular invasion or and ≥4 lymph node metastases were found more common in the early recurrence group (P<0.05), while positive status of both hormone receptors and non-standardized hormone therapy were more frequently seen in the late recurrence group (P<0.05). In the late recurrence group, initial lung metastasis was seen in 47.7% of patients, significantly higher than that (25.1%) in the early recurrence group (P<0.001). Although initial multiple organ metastases were more common in the late recurrence group (P<0.05), its median overall survival (OS) after recurrence was 66 months, significantly longer than that of the early recurrence group (39 months) (HR=1.6, P=0.003). CONCLUSIONS: The two groups of HER2-negative luminal-type breast cancer patients with early and late recurrence show some differences in clinicopathological features and prognosis. Both vascular invasion and ≥4 lymph node metastases are important factors affecting the DFS in HER-2-negative luminal-type breast cancer patients, and early recurrence is more frequently seen in this group. Late recurrence is the more frequent recurrence pattern in the HER-2 negative luminal type breast cancer patients, especially, in the double hormone receptor-positive patients who received non-standardized hormone therapy. The prognosis for patients with late recurrence is better than that in the patients with early recurrence. PMID: 27346403 DOI: 10.3760/cma.j.issn.0253-3766.2016.06.009 |
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