| Objective: In recent years, trends in the incidence of breast cancer continues to rise. In most parts of China, the incidence of breast cancer in female cancer have leapt in the first place. Along with the Research of basic and clinical trials, breast cancer is no longer being seen as disease must be treated with surgery, instead they can do surgery, radiotherapy, chemotherapy, hormonal therapy, and biological therapy of comprehensive therapy in the treatment of disease. Concept of breast cancer treatment is constantly updated.There is irreplaceable advantages to treat breast cancer especially hormone-dependent breast cancer by endocrine medications. The range of treating breast cancer by medicine extend from advanced breast cancer rescure treating to early-stage breast cancer aid treatment and the prevention of high-risk applications. With more new drug development and clinical trials study,hormonal medication treatment will give more hopes for breast cancer patients to be cured.Clinic for ER-positive and PR-positive breast cancer patients can choose hormonal therapy, but hormone receptor expression in different susceptibility to endocrine therapy for breast cancer is not the same. A foreign studies have shown that adjuvant therapy or treatment for metastatic breast cancer, tamoxifen for ER-positive PR expression in breast cancer is better than PR low expression of ER-positive breast cancer, indicating that For estrogen receptor-positive breast cancer, PR high expression person is more sensitive to hormonal therapy than low expression. Study of ER-positive breast cancer has been in great depth, but a little-reported for clinical pathological features of PR different expression in breast cancer, particularly prognostic analysis. In view of this, This study is to collect datas of cancer pantients from 2004 to 2010 in Hebei Province Center of diagnosis and treatment of breast disease diagnosed with primary breast cancer and underwent surgery and follow-up to see distribution,clinical characteristics and prognosis analysis of ER-positive, PR diffierent expression in breast cancer. Expecting to provide some reference for individualized treatment of breast cancer in the future.Methods: In this research,we collected 4632 operable breast cancer patients who had clear results of molecular markers(ER PR HER-2)and clear pathologieal diagnosis in Fourth Hospital of Hebei Medieal University first surgery(Breast surgery) from January 2004 to December 2010, ER positive patients was 3176, accounted for 69%, according to the standard screen of the test, and ultimately into the group of 3030 cases. Among them,1083 cases were low expression of PR, and 1947 cases were high expression of PR. All patients accepted at least once(up to three) follow-up,follow-up method: phone, to the hospital review. Setting the operation time as starting point, and patients’ s death, lost or the last follow-up time as terminal point. Disease-free survival(DFS) was calculated from the date of the operation, with first recurrences, local or distant, being scored as an event, and patients without recurrence were censored at the time of last follow-up or death. Overall survival(OS) from the date of operation, with death from any cause being scored as an event. Patients who were still alive at the time of last follow-up were censored then. Upload the follow-up data accurately to the SPSS19.0 statistical package to do the statistical analysis. Analysised of univariate factor and multivariate factor on prognosis of endocrine therapy in breast cancer patients. This study makes comprehensive analysis and evaluation of PR from relationship between PR status and clinicopathological feature as well as molecular marker and relationship between PR status and prognosis to see distribution, clinical characteristics and prognosis of breast cancer with ER-positive and PR in diffierent conditions.Results:1 The relationship between PR status and clinical pathological characteristicsThere is statistically different(P<0.05) on age, menopausal status, tumor size, pathological type, vascular invasion and lymph node metastasis,Among which order than 50 years and postmenopausal patients showed PR low expression and vascular invasion in PR low expression was more common.Compared with PR high expression group, tumor size of the low express group is bigger, the proportion of invasive ductal carcinoma is larger and more lymph node metastasis.2 The relationship between PR status and molecular markersIn breast cancers of PR different express, there is statistically different(P<0.05) in distributions. There is high proportion of high expression of Ki-67 and HER-2 positive in breast cancer for person in low expression of PR.3 The relationship between PR expression and prognosis in ER positive breast cancer with endocrine therapyMaking use of DFS and OS for the horizontal axis respectively,the survival rate as the vertical axis to draw the Kaplan-Meier survival curves,the results showed that:the DFS survival curves and OS survival curves were different between different PR expression groups.With the lower expression of PR,the shorter the DFS and OS(P<0.05).4 The prognostic analysis of ER positive breast cancer patients who received endocrine therapyUnivariate analysis of DFS and OS:age,menopausal status,tumor size,lymph node metastasis,pathology,surgery mode and postsperative treatment were the significant factors to DFS and OS of operable breast cancer patients(P<0.05),Mutivariate analysis showed that:age,tumor size,lymph node metastasis and the PR status were the independent prognostic factors to DFS and OS(P<0.05).Conclusion:1 In ER positive breast cancer, PR low expression group display features of a more aggressive biologic phenotype than PR high expression group. It is more common that the emergence of vaseular tumor thrombus exists, and in women more than 50 years of age and postmenopausal women, the PR low expression group are found more frequently than PR high expression group. And compared with PR high expression group, the tumor size is larger, the ductal carcinoma accounted more and more lymph nodes metastasis in the PR low group.2 The independent prognostic factors of OS and DFS are: age, tumor size, lymph node metastasis and the PR status in the ER positive breast cancer which received endocrine therapy. When accurately measured, low expression of PR is an independent poor prognosic factor in ER positive breast cancer. |
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