摘要
目的分析21基因复发分数(recurrence score,RS)检测在乳腺浸润性小叶癌(invasive lobular carcinoma,ILC)中的临床应用价值。方法回顾性分析2011年1月至2017年11月于上海交通大学医学院附属瑞金医院乳腺疾病诊治中心接受手术并行21基因RS检测的乳腺ILC患者,并分析其与患者临床病理特征的关系,以及21基因RS对乳腺ILC辅助化疗选择的影响。结果共59例乳腺ILC患者入组并接受21基因RS检测,其中低危患者10例(16.95%)、中危患者30例(50.85%)、高危患者19例(32.20%)。多因素分析提示ILC分子分型状态是21基因RS高危的独立影响因素(OR=19.90,95%CI:2.42~163.63,P=0.005)。单因素分析显示,乳腺ILC患者的Ki-67表达水平、分子分型状态以及21基因RS与辅助化疗选择相关(P<0.05);多因素分析显示,21基因RS不影响乳腺ILC患者辅助化疗的选择(P=0.527),而ILC分子分型状态是影响辅助化疗选择的独立影响因素(OR=14.70,95%CI:1.59~136.23,P=0.018)。结论 21基因RS危险度与乳腺ILC的分子分型状态相关;影响乳腺ILC患者行辅助化疗的主要因素为ILC分子分型的状态,21基因RS并未影响其辅助化疗选择。
Objective To analyze the clinical value of 21-gene recurrence score （RS） in invasive lobular breast cancer （ILC）. Methods We retrospectively enrolled ILC patients who underwent breast cancer surgery and 21-gene RS testing in the Comprehensive Breast Health Center at Rujin Hospital,Shanghai Jiaotong University School of Medicine between January 2011 and November 2017.Relationships of 21-gene RS with clinicopathological factors and choice of adjuvant chemotherapy were further analyzed in terlns of odds ratio （OR） and confidence intmwal （CI）. Results A total of 59 ILC patients who underwent 21-gene RS testing were enrolled, of whom 10 （16.95%） were classified as low risk;30 （50.85%）,as intermediate risk;and 19 （32.20%）,as high risk. Both univariate and multivariate analysis demonstrated that molecular subtype status was independently associated with high risk based on 21-gene RS （0R=19.90,95%CI： 2.42-163.63, P=0.005 ）. Multivariate analysis showed that molecular ILC subtype independently influenced use of adjuvant chemotherapy （OR=14.70,95%CI：1.59-136.23,P=0.018）,whereas 21-gene RS did not （P=0.527）. Conclusion The 21- gene RS was associated with molecular ILC subtype. Use of adjuvant chemotherapy was related to molecular ILC subtype but not to 21-gene RS, which deserves further clinical study.
作者
陈小松
高卫奇
吴佳毅
林琳
黄欧
何建蓉
朱丽
陈伟国
李亚芬
沈坤炜
Chen Xiaosong;Gao Weiqi;Wu Jiayi;Lin Lin;Huang Ou;He Jianrong;Zhu Li;Chen Weiguo;Li Yafen;Shen Kunwei(Comprehensive Breast Health Center,Rujin Hospital,Shanghai Jiaotong University School of Medicine;Department of Clinical Laboratory, Rujin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China)
出处
《中国癌症防治杂志》
CAS
2018年第3期172-177,共6页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
基金
上海市科委技术委员会科技创新行动计划(15411952500
15411952501)
上海市科学技术委员会医学引导类基金资助项目(15411966400)
关键词
乳腺肿瘤
浸润性小叶癌
21基因复发分数
辅助化疗
分子分型
Breast neoplasms
Invasive lobular carcinoma
21-gene recurrence score
Adjuvant chemotherapy
Molecular subtype
