Molecular Typing Of Breast Cancer In Different Age And Its Correlation With Prognosis

Objective:This study analyzed the clinicopathological features of breast cancer patients of different age groups,and studied the tumor size,lymph node status,histological grade,vascular tumor thrombus,estrogen receptor(ER)status,progesterone receptor(PR)status of breast cancer in different age groups.Whether the expression of Ki-67 is different in human epidermal growth factor receptor(EGF receptor-2H2),to explore the molecular typing characteristics of breast cancer in different age and different menstrual state,and to analyze the correlation between the expression of Ki-67 and prognosis.To evaluate the prognosis of breast cancer and guide individual treatment.Methods:1.The data collected from January 1,2008 to December 31,2013 in the breast center of Guangdong Maternal and Child Health Care Hospital were retrospectively analyzed.According to age,all patients were divided into three groups:less than 35 years,36-55years and over than 55 years.All patients were followed up.Time ends up to December 31,2017.2.The data were analyzed by SPSS 19.0 software.The relationship between age and menstrual status,tumor size,axillary lymph node status,ER status,PR status,HER-2expression and Ki-67 were analyzed byχ~2 test.Survival analysis was carried out by using Kaplan.Meier method and log.Rank test to compare survival rate and Cox regression.The difference was significant in p<0.05 definition.Results:1.Clinicopathological features of 701 patients with breast cancerIn this study,701 cases of breast cancer,including 93 people were no more than 35 years old(13.3%),497 people in 36-55 years of age(70.9%),111 people were older than 55 years old(15.8%),were examined by chi chi ~2 test to compare the clinicopathological indexes of breast cancer of different ages.The results suggest that there is a significant difference in the expression of ER,PR,Ki-67 expression and molecular typing in different group.The positive rate of ER in younger than 35 years old group was the lowest(44.1%).And the 36-55 year old group was significantly higher than it.The positive rate of PR in the 36-55 year old group was the highest,and there was a significant difference between the group aged less than equal to or equal to 35 and greater than equal to or equal to 55.In the expression level of Ki-67,the ratio of Ki-67≥14%in the 36-55 year old group is the highest,and it significantly differed from the group aged no more than 35 and older than55.The proportion of Luminal B1 in the>55 year old group was the lowest(12.6%),and was significantly different from that of the other two groups.Over 55 years old group had the highest proportion of HER-2 overexpression,the group younger than 35 years old canme second,the lowest in 36-55 years old group.2.Prognosis of breast cancer(1)Prognosis of breast cancer at different agesKaplan-Meier was used to analyze the disease-free survival and overall survival of the three groups.Log-rank compared the disease-free survival rate and overall survival rate among the groups.The results showed that the total survival of the 36-55 year old group was better than the≤35 year old group and the>55 year old group,while the disease-free survival rate between the three groups was not statistically significant.(2)Prognosis of different molecular subtypes of breast cancerKaplan-Meier was used to analyze the disease-free survival and overall survival of the 5subtypes of the patients.Log-rank compared the disease-free survival rate and overall survival rate among the groups.The results showed that there was a statistical difference between the disease-free survival time and the total survival time of the subtypes of each molecule.The disease-free survival and total survival of the triple negative type patients were inferior to those of the other molecular subtypes.3.Regression analysis of risk factors of recurrence and metastasisUnivariate factor analysis showed that tumor size,lymph node metastasis,histological grading,clinical staging,vascular tumor thrombus,ER status,PR status,Ki-67 expression level,molecular typing were closely related to recurrence and metastasis.COX multivariate regression analysis was a variable of recurrence or no recurrence,and 9variables were statistically significant in univariate factor analysis.As an independent variable,the multiple factor regression analysis of forward COX was carried out.It was found that the tumor size,the number of lymph node metastases,and the histological grade were the risk factors for the recurrence and metastasis.4.Regression analysis of the risk factors of overall survivalUnivariate factor analysis showed that age,menstrual state,number of lymph node metastases,staging,vascular tumor thrombus,ER status,PR status,and molecular typing were closely related to the total survival.If death was used as a dependent variable,the 8variables of statistical significance were analyzed by single factor analysis as independent variables,and the results showed the impact of the COX regression analysis.There are 3factors for overall survival:age,number of lymph node metastases and PR status.5.Determination of risk indexThe risk factors of COX multivariate regression analysis were taken into the equation,and the recurrence and metastasis risk index and the overall survival risk index were obtained respectively.(1)Recurrence and metastasis risk indexPI=0.269*tumor size 1+0.997*tumor size 2+0.353*lymph node metastasis number1+0.982*lymph node metastasis number 2+2.576*lymph node metastasis number3+0.043*histological grade 1+1.015*histology grading 2(2)Overall survival risk indexPI=-0.028*age 1+0.556*age 2+0.879*lymph node metastasis 1+1.048*lymph node metastasis 2+3.048*lymph node metastasis 3+1.855*PR statusConclusions1.In the 3 age group,the Luminal B1 type ratio in the>55 year old group was the lowest.The ratio of HER-2 overexpression in the>55 year old group was the highest,the group aged≤35 year old came next,and the lowest in the 36-55 years old group.2.The overall survival of the 36-55 year old group was better than that of the younger than≤35 years group and the>55 year old group,while the disease-free survival rate between the three age groups was not statistically significant.The disease free survival and overall survival of patients with triple negative breast cancer type were poorer than those of other molecular subtypes.3.Univariate analysis showed that tumor size,lymph node metastasis,histological grading,clinical staging,vascular tumor thrombus,ER status,PR status,Ki-67 expression level,molecular typing were closely related to recurrence and metastasis.COX multivariate regression analysis found that tumor size,lymph node number and histological grade were the risk factor of recurrence and metastasis.4.Univariate factor analysis showed that age,menstrual state,number of lymph node metastases,staging,vascular tumor thrombus,PR status,and molecular typing were closely related to overall survival.COX multivariate regression analysis found that age,lymph node number and PR status were the risk factors for total survival.