孕激素受体表达与乳腺癌患者临床病理特征的关系及对预后的影响

Association between progesterone receptor status and clinicopathological characteristics of breast cancer patients and its impact on prognosis

关键词:  乳腺癌  孕激素受体  临床病理特征  预后

Key words:  breast neoplasm  progesterone receptor  clinicopathological feature  prognosis

摘要:

目的　探讨孕激素受体（progesterone receptor，PR）的表达情况与乳腺癌患者临床病理特征的关系以及对预后的影响。方法　收集2012年1月1日至2015年12月31日1311例原发性乳腺癌患者病例资料，根据PR的不同表达情况分为PR（+）组与PR（-）组，PR（+）的患者再按PR的不同阳性百分比分为1%～10%、11%～33%、34%～66%、67%～100%四组。比较各组的临床病理特征及预后的差异。结果 　1311例患者中，PR（+）组患者902例，PR（-）组患者409例。PR（+）组患者肿瘤的组织学分级相对较低、肿瘤大小主要集中在T1期、临床分期主要集中在ⅠA期，ER表达阳性率高、Her-2表达阳性率低、Ki-67表达水平相对较低；而PR（-）组患者肿瘤的组织学分级相对较高、肿瘤大小主要集中在T2期、临床分期主要集中在ⅡA期，ER表达阳性率低、Her-2表达阳性率高、Ki-67表达水平相对较高。4年总生存（OS）：PR（+）组为98.3%，PR（-）组为98.1%，两组间无统计学差异（P=0.829）。按PR阳性百分比分组后，PR阳性细胞百分比越高，组织学分级越低、肿瘤越小、ER表达阳性率越高、Her-2表达阳性率及Ki-67表达水平越低。各组生存率分别为96.9%、97.2%、98.2%、98.8%，各组间OS无统计学差异（P=0.548）。 结论　PR表达情况对于乳腺癌患者术后OS无明显影响，但PR高表达可能是早期乳腺癌患者术后长期生存的预测指标。

Abstract:

Objective To investigate the correlation between the expression of progesterone receptor (PR) and clinicopathological features of breast cancer patients and its prognostic significance. Methods We retrospectively analyzed the clinical data of 1311 breast cancer patients, who were treated in our hospital during the period from January 1, 2012 to December 31, 2015. The patients were divided into PR（+）group and PR （-）group according to PR expression status, and the PR (+) patients were further divided into four groups according to the different PR positive percentages: 1%-10%, 11%-33%, 34%-66%, and 67%-100%. Then we tried to explore whether there were differences in the clinicopathologica features and prognosis between each group. Results Of the 1311 patients, 902 were PR (+)and 409 were PR (-). The histological grade of PR（+）breast cancer was relatively low, the tumor size was mainly concentrated in the T1 stage, and the clinical stage was mainly concentrated in theⅠA stage. ER expression positive rate was high, Her-2 expression positive rate was low, and the expression level of Ki-67 was relatively low. In contrast, the histological grade of PR(-) breast cancer was relatively high, and the tumor size was mainly concentrated in the T2 phase and the clinical stages were mainly concentrated in the ⅡA stage, with low ER expression positive rate, high Her-2 expression positive rate, and relatively high Ki-67 expression level. Total 4-year survival (OS) was 98.3% in PR (+) group and 98.1% in PR (-) group, with no significant difference (P=0.829). After grouping by PR positive percentage, the higher the percentage of PR positive cells, the lower the histological grade, the smaller the tumor, the higher the ER expression positive rate, the lower the Her-2 expression positive rate, and the lower the Ki-67 expression level. The survival rates of each group were 96.9%, 97.2%, 98.2% and 98.8%, respectively. But there was no statistical difference in OS among the groups (P=0.548). Conclusions PR expression has no significant impact on OS of breast cancer patients, but higher PR expression may be a longer survival predictive factor of early breast cancer patients.