| Background: Breast cancer is a common malignant tumor,even in young women.Endocrine therapy is an important treatment,however,some patients were with ER/PR single positive.For them,studies have shown that the prognosis is worse.However,there are few studies in young women.And some patients with ER 1%-9% positive,study showed the prognosis was closer to that of patients with ER negative.Whether this conclusion can be extended to young female patients has not been confirmed yet.Objective: To study the characteristics and prognosis of young breast cancer patients with single positive expression of ER or PR,and to explore the differences between young patients with ER1%-9% and those with negative or high expression of ER,and the effect of endocrine therapy in single positive expression or low expression group.Methods: From 2006.1 to 2016.12,patients aged18-35 y in Tianjin Medical University Cancer Hospital were selected and were followed up.Patients were divided into ER+/PR+,ER+/PR-,ER-/PR+,ER-/PR-groups.Then patients were divided into ER<1%,ER1%-9% and ER positive≥10% groups.The characteristics and prognosis were compared.Spss20.0 was used for statistical analysis.Chi square test was used for counting data.Kaplan Meier survival curve was drawn.Log-Rank test was used to compare the OS and DFS between groups.Cox proportional hazards model was used to analyze independent prognostic factors.All P values were two tailed distribution,P<0.05 was significant difference.Result:1 1387 patients were enrolled.The median age was 32 years and the median follow-up time was 74 months.2 92.72% of patients were ductal carcinoma,43.76% had LN+,ER+ was 69.57%;PR+ was 67.56%,Her-2+ was 18.67%.T,N,ER status were independent prognostic factors of DFS and OS;Her-2 status was also independent prognostic factors of OS.3 ER/PR single positive patients was 5.91% and 3.89% respectively.4 The features of ER+/PR-were similar to ER+/PR+.DFS of ER+/PR+ was better than ER+/PR-(P<0.05).T,N,TNM of ER-/PR+ were higher than ER+/PR+,and more patients with histological grade 3,more Her-2+ and higher Ki-67(P<0.05).The DFS and OS of ER+/PR+ were better than ER-/PR+(P<0.05).ER-/PR+ had more histological grade 3 and worse OS than ER+/PR-(P<0.05).With endocrine therapy,DFS(P=0.09)and OS(P=0.05)of ER+/PR-were improved,but was not significant.There was no significant improvement in DFS and OS in ER-/PR+(P>0.05).5 ER 1%-9% accounted for 4.25%.The features of ER 1%-9% were similar to ER-.They had more LN+,higher histological grade,more Her-2+ and higher Ki-67 index than ER≥10%(P < 0.05).6 There was no difference in DFS and OS between ER<1% and ER 1%-9%;OS of ER 1%-9% was significantly worse than ER≥10%(P < 0.05).7 Endocrine therapy did not improve DFS and OS in ER 1%-9%.Conclusion:1 The prognostic factors of DFS and OS were T stage,N stage,ER/PR status,Her-2status and Ki-67 index.T stage,N stage,ER status were independent prognostic factors of DFS and OS;Her-2 status were also independent prognostic factors of DFS.2 The clinicopathological features of ER+/PR-are similar to those of ER+/PR+.ER-/PR+ was more malignant than ER+/PR+.3 The prognosis of ER+/PR+ was better than that of ER/PR single positive,and the prognosis of ER-/PR+ was the worst.4 Endocrine therapy improved DFS and OS of ER+/PR-,but it has not yet reached statistical difference.Endocrine therapy had no significant effect on DFS and OS of ER-/PR+.5 The low expression of ER in features of clinicopathological is similar to the ER negative patients,and is more malignant and invasive than the high expression of ER.The prognosis was similar to that of ER negative patients,and OS was significantly shorter than that of ER high expression patients.Endocrine therapy did not prolong DFS and OS in patients with low ER expression. |
PDF Full Text Request