The Analysis Of Breast Cancer Molecular Typing For Time And Location Of Distant Metastasis

Objective:Find out the risk distribution of breast cancer for time and location of distant metastasis in molecular typing, and try to find the law may exist,to provide evidence for patients for assessing the prognosis and individual screening of distant metastasis.Methods:We study retrospectively the female patients who were diagnosed as invasive ductal breast cancer in our hospital from January 2000 to January 2009, Including the patients who got the first treatment outside hospital, but were clarified for their pathological diagnosis by our Department of Pathology consultation with paraffin sections.and detect the ER, PR, HER2 expressed in the paraffin sections,then track these patients for survival by follow-up means.The patients with distant metastasis are divided into visceral metastasis and non-visceral metastasis with the first transfer site as standard,for analysing the distribution in molecular typing and the time of the first site of distant metastasis.We analyze the difference of transfer rate between groups by Non-parametric test and estimate hazard function for every six months by COX hazard function estimate, then test the difference survival of groups by life tables.The statistical software adpoted is SPSS13.0.Results:1 There are 129 patients encountered distant metastasis who were diagnosed as breast invasive ductal carcinoma in our hospital from January 2000 to January 2009 ,including 78 patients with visceral metastasis ,and 51 patients with non-visceral metastasis. The survival rate of patients with visceral metastasis is lower than those with non-visceral metastasis;2 The rate of visceral metastasis for patients'who belong to luminalA type is lower than that of non-visceral metastasis(P =0.06),and the rates of visceral metastasis for patients who belong to HER2 type and basal-like type are higher than that of non-visceral metastasis(P =0.01,P =0.001);3 The patients whose tumor belong to T1 have higher rate of distant metastasis to non-viscera(P =0.032),and those belong to T3-4 have higher rate of diatant metastasis to viscara(P =0.001);when we divide these patients by node state,we find that patients with different node state have different rate of distant metastasis,but no difference between viscara and non-viscera when in the same state(P =0.10).4 The risk distribution of transfer events for every six months: the risk function curve of molecular types shows that, the peak of luminalA type is lowest,delayed, prompt that the risk of distant metastasis is low in 3 years after the operation,and the basal-like's is highest,advanced, prompt that the risk of distant metastasis is high in 3 years after the operation,.More than 50% of the transfers occurred at the 3thyear after the operation,the first metastasis peak occurred at the 2.5thyear after the operation,and the second occurs at the 7th year.The Visceral metastasis risk function curve shows that, the first metastasis peak occured at the 1.5th year,and the peak is higher,The non-visceral metastasis risk function curve shows that the first metastasis peak is delayed than the former,and the peak is lower. Conclusions:As an important tool for assessing the prognosis of patients,molecular typing of breast cancer can assess the patients of diatant metastasis for time and location more accurately,is an important complement for TNM method,for helping the individual screening of patients for distant metastasis.