Study On The Relationship Between The Molecular Subtypes Of Breast Cancer With Axillary Lymph Node Metastasis

ObjectiveThe most common malignant tumor of female breast cancer, due to many factors, prognosis and outcome of the complexity of the situation, a serious threat to the health of women, and the incidence rate is rising year by year, the age of onset is younger. With the development of molecular biology technology advances and clinical diagnostic methods, clinical and basic research on breast cancer has made great progress, early breast cancer detection rate and increasing the cure rate, mortality decreased significantly, there are still many problems to be solved puzzles but for breast cancer, clinical study found that patients with breast cancer even with the same pathological types, and the treatment of the same specification, a statistically significant difference in the sensitivity of comprehensive treatment and the prognosis of the patients. In fact, breast cancer is the molecular heterogeneity, the height of the clinical manifestations, treatment and prognosis are different tumors may have the same morphology. For a long time, often to the tumor morphology as a treatment for clinical basis, the traditional TNM staging for local recurrence, predict the metastasis of the tumor has an important value, is one of the risk assessment index of mature clinical. But with the continuous development of medical molecular biology, and staging of pathological diagnosis development needs of breast cancer research is not in the traditional, application of molecular diagnostic techniques, the new hot spot of the current research of breast cancer is a pathology at the molecular level for breast cancer development mechanism and biological behaviors of. High molecular heterogeneity of breast cancer suggests that breast cancer may have different molecular subtypes, there were significant differences of clinical characteristics, response of breast cancer molecular subtypes to treatment and prognosis. The proposed molecular tumor expression breast cancer molecular subtypes based differences to solve the heterogeneity of breast cancer, pathology as an important theoretical basis can guide reasonable staging accuracy analysis, determine the outcome of breast cancer and breast cancer treated with individual. The judge has been one of the important prognostic indicator in breast cancer breast cancer axillary lymph node metastasis, so breast cancer molecular subtypes and axillary lymph node metastasis, whether to have a certain relationship? According to the study of breast cancer cells of estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor 2(HER-2) expression in breast cancer, will be divided into Lumina1 A type, Lumina1 B type, HER-2 type, Basal-like type expression of four subtypes, the biological behavior of breast cancer to make clear in response, and as the individualized treatment of breast cancer and accurate prognosis important theoretical basis, and to further explore the relationship between clinical and pathological characteristics of breast cancer and axillary lymph node metastasis and four molecular subtype relationship, provide sufficient basis for the evaluation of individual treatment and the prognosis of breast cancer research. MethodThrough retrospective analysis, since 2009 January to 2013 October were collected in the Department of general surgery, Zaozhuang municipal hospital by operation and 380 cases of breast cancer confirmed by pathology, according to the results of immunohistochemistry in breast cancer molecular typing standard were divided into type Luminal A, type Luminal B, overexpression of HER-2 type, Basal-like type four kinds, statistical comparison of the pathological types were the distribution proportion, tumor size, lymph node metastasis(lymph node metastasis and metastasis rate) and other basic information, and the data by SPSS17. 0 statistical software for statistical analysis, the relationship between different genotype in breast cancer with lymph node metastasis. Result1. in 380 cases of breast carcinoma, Lumina1 B accounted for the largest proportion, a total of 194 cases(51.1%); the over expression of HER-2 in 22 cases(14.60%), type Lumina1 A in 57 cases(13.2%), the lowest proportion of type Basal-like, 31 cases(8.2%).2. in 380 cases of breast carcinoma with axillary lymph node metastasis, 147 cases, accounting for 38.7%; no axillary lymph node metastasis in 233 cases, accounting for 61.3%. The Luminal B lymph node metastasis rate(57.7%) the highest, followed by HER-2 positive type(23.5%), Luminal A(17.5%), Basal-like(6.5%). The difference was statistically significant(P<0.05).3. in 380 cases of breast cancer patients, 57 cases of type Luminal A, 10 cases with lymph node metastasis, metastasis rate of 17.5%; 194 cases of type Luminal B, 112 cases with lymph node metastasis, metastasis rate was 57.7%; the HER-2 positive in 98 cases, 23 cases with lymph node metastasis, distant metastasis rate was 23.5%; 31 cases of Basal-like type, lymph node metastasis in 2 cases, the metastatic rate was 6.5%, the different molecular subtypes of breast cancer, lymph node metastasis and there was a significant difference(P<0.05), where Luminal B lymph node metastasis rate of Basal-like is highest, the lowest rate of lymph node metastasis.4. 380 cases of breast cancer patients, l in 57 patients with Lumina A, 2 cases of lymph node metastasis ≥ 3, metastasis rate was 17.5%, in 194 patients with Luminal B lymph node metastasis ≥ 3 in 16 cases, metastatic rate was 57.7%, 18 cases with over expression of HER-2 in 98 patients with lymph node metastasis ≥ 3, metastasis rate was 23.5%, in 31 patients with Basal-like ≥ 3, lymph node metastasis of lymph nodes, metastasis rate was 6.5%.5. in the cases with lymph node metastasis, Luminal A mainly distributed at the level of 1; Luminal B in addition to the 1 level, 10 cases were transferred to the 2 level; HER-2 expression in addition to the 1 level, 4 cases were transferred to the 2 level, 3 cases were transferred to the 3 level of Basal-like type 3 level; see the metastatic lymph nodes. Conclusion1. breast cancer can be well reflected by the molecular subtypes and Biological characteristics of of breast cancer, due to the high molecular heterogeneity of breast cancer, so that different molecular types of breast cancer with clinical and pathological characteristics of different.2. breast cancer of different molecular subtypes and Clinical pathological characte ristics,decide the lymph node metastasis and different transfer rule, has an important guiding significance for the treatment and prognosis of breast cancer.3. based on the difference of molecular biology, the type of breast cancer molecular subtypes, explore the subtype rule of lymph node metastasis in a molecule, will help to better guide the individualized breast cancer treatment options.