Axillary Lymph Nodes Metastasis of Various Breast Cancer Molecular Subtypes and Its Prognostic Analysis_West China Medical Journal

Authors：

CHEN Bo , XUE Mingxing , YE Chunmei , HUANG Ziming , WANG Rong , ZHAO Song

Department of Breast Surgery, Maternal and Child Health Hospital of Hubei Province, Wuhan, Hubei 430070, P. R. China;

Corresponding author：

Keywords：

乳腺肿瘤; 分子亚型; 淋巴结转移; 预后

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【摘要】　目的　探讨乳腺癌不同分子亚型腋窝淋巴结转移的状态及预后分析。　方法　对2005年1月－2007年12月收治的125例乳腺癌患者进行分子分型，对腋窝淋巴结转移状态进行分析并结合随访结果进行预后分析。　结果　 Luminal A型63例，16例淋巴结转移，转移率为25.4%；Luminal B型19例，7例淋巴结转移，转移率为36.8%；HER-2过表达型26例，11例淋巴结转移，转移率为42.3%；Basal-like 型17例，9例淋巴结转移，转移率为52.9%。其中Luminal A型淋巴结转移率与Basal-like 型比较差异有统计学意义（P lt;0.05），其余型间比较差异无统计学意义（P gt;0.05）。运用χ2检验各分子亚型在肿瘤大小的差异无统计学意义（P gt;0.05）。经过2~5年随访，8例患者出现局部复发或远处转移，其中Luminal B型2例，HER-2过表达型5例，Basal-like 型1例。8例中有3例因肝转移死亡，另5例接受治疗现仍生存。　结论　乳腺癌的分子分型可作为腋窝淋巴结转移的预测指标，HER-2过表达型和Basal-like 型预后较差，将为今后制定乳腺癌个体化治疗提供重要依据。
【Abstract】　Objective　 To analyze the axillary lymph nodes metastasis of various breast cancer molecular subtypes and its prognosis.　Methods　 Molecular subtypes of 125 cases of operable breast cancer diagnosed and treated between January 2005 and December 2007 were categorized, and the axillary lymph nodes metastasis of these types was analyzed. At the same time, we analyzed its prognosis status with the results of the follow-up.　Results　 Among the 125 cases, there were 63 luminal A cases in which 16 (25.4%) were found to be axillary lymph nodes metastasis. Among the 19 luminal B cases, there were 7 (36.8%) axillary lymph nodes metastases. There were 11 cases (42.3%) of axillary lymph nodes metastasis in the 26 cases of HER-2 (+) subtype. In the 17 cases of basal-like subtye, 9 (52.9%) were axillary lymph nodes metastases. As for the axillary lymph nodes metastatic rate, only basal-like subtype was higher than luminal A subtype with a statistically significant difference (P lt;0.05). Differences between all other subtypes were not significant (P gt;0.05). The molecular subtypes did not differ in tumor size (P gt;0.05) according to the result of chi-square test. During the 2 to 5-year follow-up, 8 of the 125 patients were found to have local tumor recurrence or distant metastatic disease, which included 2 luminal B cases, 5 HER-2 (+) subtype cases, and 1 basal-like subtype case. In those 8 patients, 3 died of liver metastases and 5 survived and are still accepting treatment now.　Conclusions　 Molecular subtyping can provide important information of axillary lymph nodes metastatic status. HER-2 over-expression and basal-like subtype have a poor prognosis, which is an important basis for individual treatment of breast cancer in the future.

Citation： CHEN Bo,XUE Mingxing,YE Chunmei,HUANG Ziming,WANG Rong,ZHAO Song. Axillary Lymph Nodes Metastasis of Various Breast Cancer Molecular Subtypes and Its Prognostic Analysis. West China Medical Journal, 2011, 26(7): 971-974. doi: Copy

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1. 　Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study[J]. JAMA, 2006, 295(21): 2492-2502.
2. 　Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumors[J]. Nature, 2000, 406(6797): 747-752.
3. 　Ihemelandu CU, Naab JT, Mezghebe HM, et al. Basal cell-like (triple-negative) breast cancer, a predictor of distant metastasis in African American women[J]. Am J Surg, 2008, 195(2): 153-158.
4. 　Carey LA, Dees EC, Sawyer L, et al. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes[J]. Clin Cancer Res, 2007, 13(8): 2329-2334.
5. 　Liu H, Fan Q, Zhang Z, et al. Basal-HER2 phenotype shows poorer survival than basal-like phenotype in hormone receptor-negative invasive breast cancers[J]. Hum Pathol, 2008, 39(2): 167-174.
6. 　Badve S, Turbin D, Thorat MA, et al. FOXA1 expression in breast cancer-correlation with luminal subtype A and survival[J]. Clin Cancer Res, 2007, 13(15 Pt 1): 4415-4421.
7. 　Millikan RC, Newman B, Tse CK, et al. Epidemiology of basal-like breast cancer[J]. Breast Cancer Res Treat, 2008, 109(1): 123-139.
8. 　Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy[J]. Clin Cancer Res, 2005, 11(16): 5678-5685.
9. 　Ihemelandu CU, Naab JT, Mezghebe HM, et al. Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival[J]. J Surg Res, 2007, 143(1): 109-118.〖ZK)〗.
10. 　Sϕrlie T. Molecular portraits of breast cancer: tumour subtypes as distinct disease entities[J]. Eur J Cancer, 2004, 40(18): 2667-2675.
11. 　Livasy CA, Karaca G, Nanda R, et al. Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma[J]. Mod Pathol, 2006, 19(2): 264-271.
12. 　Kim MJ, Ro JY, Ahn SH, et al. Clinicopathologic significance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes[J]. Hum Pathol, 2006, 37(9): 1217-1226.
13. 　徐兵河, 张萍. 乳腺癌的分子分型与个体化治疗[J]. 中华肿瘤杂志, 2010, 32(9): 641-644.
14. 　Voduc KD, Cheang MC, Tyldesley S, et al. Breast cancer subtypes and the risk of local and regional relapse[J]. J Clin Oncol, 2010, 28(10): 1684-1691.
15. 　Wong FY, Chin FK, Lee KA, et al. Hormone receptors and her-2 status as surrogates for breast cancer molecular subtypes prognosticate for disease control in node negative asian patients treated with breast conservation therapy[J]. Ann Acad Med Singapore, 2011, 40(2): 90-97.

West China Medical Journal

Axillary Lymph Nodes Metastasis of Various Breast Cancer Molecular Subtypes and Its Prognostic Analysis

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