A 10-year Survival Analysis towards Molecular and Clinical Factors in Taiwan Breast Cancer Patients

台灣乳癌病患10年存活率與相關分子和臨床變數之分析

蔡欣恬(Hsin-Tien Tsai) ； 黃其晟(Chi-Cheng Huang) ； 陳楷模(Kai-Mo Chen)

《輔仁醫學期刊》 9卷4期 (2011/12) Pp. 181-189

摘要

研究背景：近年來乳癌是婦女腫瘤的主要死因之一，因為乳房腫瘤在基因和表現性狀上十分多樣，本研究因此設計來探討數個分子標記與已知與預後有關的因子在台灣乳癌病患的表現。研究方法：自1999年開始總計有146位接受手術切除病灶的原發性乳癌病患，因為追蹤時間長逾10年，最後有76位病患進入統計。所有病患皆由同一位外科醫師進行手術，術後亦接受一致的療程與相關分子標記之定量。研究結果：76位病患中有21位HER-2/neu受體過度表現 （27.6%），相較於未過度表現之病患，過度表現者有較高之病理期別、較少的黃體素受體及動情素受體陽性率、以及較短的無病生存期。不過，黃體素受體及動情素受體陽性率並不影響生存率，HER-2/neu受體是否過度表現的兩組在年齡、淋巴侵犯情形、以及腫瘤大小上也無差異。研究結論：HER-2/neu受體的過度表現與否於病患的臨床表現確有影響。其他相關的因子亦應被考慮於乳癌病患的相關研究中。

關鍵字

乳癌 ； HER-2/neu受體 ； 人類上皮生長因子第二型 ； 黃體素受體 ； 動情素受體

並列摘要

Background: Breast cancer is one of the major cancers responsible for female deaths in recent years. Since both molecular and pathological aspects of breast tumors are quite diverse among different races and tumor histological types, this study was designed to investigate the relationship of several molecular markers with other known prognostic factors in Taiwanese women with breast infiltrative ductal carcinoma. Methods: In total, 146 patients with primary, resectable breast cancer were consecutively recruited into this study from 1999. Seventy-six patients remained available for analysis due to a long (＞ 10 years) follow-up period. All patients received a modified radical mastectomy by a single surgeon. After surgery, concentrations of the estrogen receptor (ER) and progesterone receptor (PR) and the expression of human epidermal growth factor receptor (HER)-2/neu were determined by an immunohistochemical analysis, and patients were treated according to standard protocols. Only patients with infiltrative ductal carcinoma were analyzed. Results: Twenty-one of 76 patients (27.6%) with infiltrative ductal carcinoma were found to be overexpressing HER-2/neu. Compared to patients without HER- 2/neu overexpression, patients with HER-2/neu overexpression were associated with advanced pathological stages, less ER- and PR-positivity, and shorter disease-free survival. In the Kaplan- Meier analysis, survival of patients overexpressing HER-2/neu was similar to that of patients without HER-2/neu overexpression. Moreover, neither hormone receptor (ER or PR) status was prognostic for survival. The two groups of patients were also similar in age, nodal status, and tumor size. Conclusions: Compared to previous reports, HER-2/neu is as an effective prognostic marker in breast infiltrative ductal carcinoma of Taiwanese women. Results suggest that histological and ethnic factors should be considered in future cancer studies.

並列關鍵字

breast cancers ； HER-2/neu ； ERBB2 ； estrogen receptors ； progesterone receptors