雌、孕激素受体状况对青年乳腺癌的远期预后价值

Long term prognostic value of estrogen receptor and progesterone receptor in young patients with breast carcinoma

摘要:

目的：探讨雌激素受体（estrogen receptor，ER）、孕激素受体（progesterone receptor，PR）状况对青年乳腺癌的远期预后价值。方法：对370例≤35岁乳腺癌患者用免疫组化方法检测ER及PR状况，并随访。结果：370例中366例随访，随访时间24～288月，平均132.46月。ER及PR阳性率分别为44.86%（166/370）和38.11%（141/370）。ER及PR状况与2年及5年生存率无明显相关，8、10、15年生存率中ER（+）与ER（-）组之间的差异有统计学意义（ χ2=5.992，P=0.014； χ2=7.025，P=0.008； χ2=6.221，P=0.013）；PR（+）组8年生存率明显高于PR（-）组（ χ2=9.552，P=0.002）；ER（+）PR（+）组的2年生存率与ER（-）PR（-）组无差异（ χ2=1.963，P=0.161），5年及8年生存率明显高于ER（-）PR（-）组（ χ2=7.365，P=0.007； χ2=5.236，P=0.022）。结论：ER及PR是影响青年乳腺癌患者中远期预后的重要因素；ER、PR同时检测对青年乳腺癌的预后更有价值，ER（-）、PR（-）及ER（-）PR（-）提示患者预后不良，应积极施行包括化疗在内的综合辅助治疗，加强随访，改善预后。

Abstract:

Objective：To investigate the effects of estrogen receptor（ER） and progesterone receptor（PR） on long term prognosis of young patients with breast cancinoma. Methods：ER and PR statuses in 370 patients with breast cancinoma（younger than 35 year） were immunohistochemical examined and followed up. Results：Totally 366 out of 370 patients were followed up for 24 to 288 months，with an average of 132.64 months. ER and PR positive rates were 44.86%（166/370）and 38.11%（141/370）respectively. ER and PR statuses were not associated with 2-year survival rate and 5-year survival rate. There were differences in 8-，10-，15-year survival rate between ER（+） and ER（-）（ χ2=5.992，P=0.014； χ2=7.025，P=0.008； χ2=6.221，P=0.013）. Eight-year survival rate in PR（+） was higher than that in PR（-）（ χ2=9.552，P=0.002）；2-year survival rate in ER（+）PR（+） was not different from that in ER（-）PR（-）（ χ2=1.963，P=0.161）；but 5-year and 8-year survival rates in ER（+）PR（+） were higher than those in ER（-）PR（-）（ χ2=7.365，P=0.007； χ2=5.236，P=0.022）. Conclusions：ER and PR are important long term prognostic factors in young patients with breast canci－noma. Simultaneous exam of ER and PR is of higher prognostic value. ER（-）PR（-） and ER（-）PR（-） indicate poor prognosis，therefore auxiliary treatment including chemotherapy should actively be put in force and followe up should be strengthen in order to improve the prognosis.