Analysis On The Correlation Of Hormone Receptor Status With Clinicopathological Features And Prognosis In Invasive Breast Cancer

Objective:The project was designed to analyze the clinicopathological traits and influence on recurrence,metastasis and overall survival of invasive breast cancer under distinct hormone receptor status,and to provide evidence for the clinical practice of the disease.Methods:This study collected the case data of female breast cancer patients pathologically diagnosed as invasive breast cancer with molecular typing at The First Affiliated Hospital of Fujian Medical University from January 2010 to December 2015,and the patients were followed up until December 31,2019.Theχ² test,multiple logistic regression and Fisher’s exact probability test were used to compare the count data.Univariate analysis,Univariate analysis,comparison between groups and multivariate survival analysis were performed by Kaplan-Meier,Log-rank and Cox regression,respectively.Results:A total of 1040 participants were collected in this study,of which 22 patients were lost to follow-up and 1018 patients had intact follow-up data.The features of the patients were:the mean age of was 50.30±11.00 years old,and the median age49（23-91）,the patients number ER+PR+were 608（59.7%）,ER+PR-88（8.6%）,ER-PR+40（3.9%）,and ER-PR-282（27.7%）.The correlation between hormone receptor status and clinicopathological features were:the proportion of ER-PR-（8.9%）was higher than ER+PR+（4.9%）and ER+PR-（3.4%）in the age of≤35years old（P=0.023）;ER+PR+（60.9%）and ER-PR+（55.0%）were dominated in premenopausal patients,so were ER+PR-（60.9%）and ER-PR-（55.0%）in menopausal patients（P=0.011）;ER+PR+（42.4%）and ER+PR-（39.8%）higher in T₁,so were ER-PR-（T₃:8.5%,T₄:3.5%）and ER-PR+（T₃:10.0%,T₄:5.0%）（P=0.002）;ER-PR-（7.5%）was the highest in M₁;ER-PR-（52.5%）was highest,followed by ER-PR+（50.0%）and ER+PR-（44.3%）,and lowest in ER+PR+（27.0%）among HER-2 positive patients（P=0.001）;ER-PR+（92.5%）and ER-PR-（91.8%）was higher in Ki-67≥14%（P=0.001）;ER-PR-（48.2%）and ER-PR+（52.5%）were higher in gradeⅢ,and the ER+PR+（17.6%）and ER+PR-（12.5%）groups were higher in grade I（P=0.001）.The influence of hormone receptor status on medium Progression Free Survival（m PFS）（months）were:ER+PR+（107.64±1.14）>ER+PR-（101.77±3.59）>ER-PR+（88.45±6.00）>ER-PR-（82.65±2.66）（P<0.001）;medium Overall Survival（m OS）（months）were:ER+PR+（111.64±0.91）>ER+PR-（107.37±2.73）>ER-PR+（96.27±4.23）>ER-PR-（89.62±2.26）（P<0.001）.Univariate analysis showed that the recurrence,metastasis,overall survival was closely related to T,N,M,hormone receptor status and HER-2 state,expression of Ki-67,histological grade,surgery status.Multivariate COX regression analysis manifested that the risk factors for recurrence,metastasis,overall survival were T,N,M,hormone receptor status and HER-2 state,histological grade.Conclusions:1.Relationship between different hormone receptor status and prognosis of invasive breast cancer:1)m OS:ER+PR+>ER+PR->ER-PR+>ER-PR-;2)m PFS:ER+PR+>ER+PR-,ER-PR+>ER-PR-.1.Hormone receptor status was correlated with age,menstrual status,T,M stage,HER-2 status,Ki-67 expression,pathological type and histological grade.ER+PR+more frequently occured in premenopausal,T₁,HER-2 negative,Ki-67<14%,histological grade I.The ER-PR-group was more commom in the invasive breast cancer of≤35 years old group,menopausal,T3-4,M1,HER-2 positive,Ki-67≥14%,and histological gradeⅢ.3.Multivariate analysis of COX regression showed that the independent risk factors of recurrence,metastasis and overall survival are T,N and M stages,hormone receptor status,HER-2 status and histological grad in invasive breast cancer.