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1、复旦学报(医学版)FudanUnivJMedSci2008Mar,35(2)269HER-2等病理特征对乳腺癌患者术后转移部位的影响■周力恒殷文瑾陆劲松狄根红吴炅沈坤炜韩企夏沈镇宙邵志敏(复旦大学附属肿瘤医院乳腺外科-复旦大学上海医学院肿瘤学系上海200032)【摘要】目的分析乳腺癌术后患者不同转移部位间的差异,从而进一步探索乳腺癌的转移规律。方法回顾性研究了210位乳腺癌术后发生复发转移的患者,并采用多因素分析对不同转移部位患者的临床及肿瘤特征进行比较。结果单因素分析显示非内脏转移(淋巴结、骨转移)患者的平均年龄显著高于内脏转移(肺、肝、脑)者(50.71比46.69,P=0.012);HE
2、R-2的阳性率则显著低于内脏转移者(10.6%比25.4%,P=0.05)。Cox回归分析结果显示年龄较大(RR=0.927,95%CI0.877～0.981,P=0.008)、HER-2阴性者(RR=0.253,95%CI0.076～0.836,P=0.024)易倾向非内脏转移;原发灶较大者(RR=3.832,95%CI1.073～13.687,P=0.039)则易向内脏转移。结论不同临床和生物学特征的乳腺癌患者可能会发生不同部位的转移,且转移的机制可能不同。【关键词】乳腺肿瘤;转移时间;危险因素【中图分类号】R737.9【文献标识码】AEffectofHER-2overexpression
3、andothertumorcharacteristicsonmetastasissitesofbreastcancerpatientsafteroperationZHOULi-heng,YINWen-jin,LUJin-song■,DIGen-hong,WUJiong,SHENKun-wei,HANQi-xia,SHENZhen-zhou,SHAOZhi-min(DepartmentofBreastSurgery,CancerHospital-DepartmentofOncology,ShanghaiMedicalCollege,FudanUniversity,Shanghai200032,C
4、hina)【Abstract】ObjectiveToanalyzethebreastcanerpatientswithdifferentsitesofrecurrence,andtohaveknowledgeoftheregularpatternofmetastaticbreastcancer.MethodsWeretrospectivelyana-lyzed210womenwithmetastaticbreastcancer.Theclinicalandbiologicalcharacteristicswerecom-paredbetweenthepatientswithorganmetas
5、tases(lung,liver,brain)andnon-viscerametastases(lymphnode,bone).TheCoxregressionanalysiswasusedtotesttheriskfactors.ResultsUni-variateanalysisindicatedthattheaverageofagewassignificantlylower(50.71vs46.69,P=0.012)inthepatientswithviscerametastases,andtherateofHER-2overexpressionwasalsosignificantlyh
6、igh-er(10.6%vs25.4%,P=0.05).Coxregressionanalysisshowedthatpatientswithelderage(RR=0.92795%CI0.877-0.981,P=0.008),HER-2negativeoverexpression(RR=0.25395%CI0.076-0.836,P=0.024)tendedtodevelopnon-viscerametastases,whilepatientswithlargertumors(RR=3.83295%CI1.073-13.687,P=0.039)tendedtodeveloporganmeta
7、stases.ConclusionsPa-tientswithdifferentclinicalandbiologicalcharacteristicsmaydeveloprecurrenceindifferentsites.Theremaybedifferentmechanismsofmetastasisforrecurrenceindifferentsites.【Keywords】breast
