【作者】 王雯；

【导师】 张巍；

【作者基本信息】 新疆医科大学 ， 病理学与病理生理学， 2014， 硕士

【摘要】 目的：了解维吾尔族、汉族女性患者乳腺癌组织的各分子分型构成比、组织学分型中各分子分型构成比是否存在差异,分析相同地区维吾尔族、汉族患者间不同分子分型和预后是否存在差异。方法：收集2001年1月——2008年12月新疆医科大学第一附属医院收治的、具有完整临床及病理资料的307例维吾尔族与汉族乳腺癌患者相关资料,其中维吾尔族患者83例,汉族患者224例。以免疫组织化学方法为基础,辅以荧光原位杂交技术,将两民族乳腺癌进行分子分型,分为4种亚型,分别为：luminal A型,luminal B型,HER-2过表达型和basal-like型；分析两民族各亚型的临床特征及预后情况。结果：维吾尔族、汉族两组乳腺癌患者临床分期构成比差异有统计学意义(χ2=8.304,P=0.016)；维吾尔族、汉族两组患者乳腺癌病理组织学分型构成比、分子分型构成比、ER/PR/HER-2/Ki-67指标表达构成比以及各分子分型中组织学类型构成比差异均无统计学意义(P均>0.05)；全组307例中有完整随访资料者271例,失访率为11.73%；运用Kaplan-Meier法对307例乳腺癌患者进行单因素分析,结果显示,民族、临床分期、PR、原发肿瘤大小、淋巴结转移、分子分型等因素的无病生存期(DFS)差异有统计学意义(P<0.05)；年龄、组织学分型、HER-2、Ki-67等因素的DFS差异无统计学意义(P>0.05)；将差异有统计学意义的指标带入Cox风险比例回归模型,结果显示淋巴结转移情况和分子分型为影响预后的风险指标。结论：维吾尔族、汉族女性乳腺癌患者的分子分型构成无差异,但其临床特征有差异；分子分型及淋巴结转移情况可作为乳腺癌患者的预后指标,指导临床治疗。更多还原

【Abstract】 Objective:To study the difference in constituent ratio of molecular typing in breast cancer tissue and in histological typing between Uyghur and Han female patients, and to analyze the correlation between molecular typing and prognosis in patients with breast cancer in two ethnicities living in the same region. Methods:307inpatients, with83Uyghur and224Han, who were admitted to hospital during January2001to December2008in the first affiliated hospital of Xinjiang medical university, were tested by Immunohistochemistry(IHC) and fluorescence in situ hybridization(FISH). All patients were divided into four molecular typing:Luminal A, Luminal B, HER-2Overexpression and Basal-like. The clinical feature and prognosis of breast cancer with one of above molecular typing in two ethnicities were analyzed too. Results:There was significant difference in constituent ratio of clinical stage between Uyghur and Han groups.(x1=8.304, P=0.016). There was no statistically significant difference in constituent ratio of pathological classification, molecular typing and ER/PR/HER-2/Ki-67expression in breast tumor cells(Ps>0.05) between Uyghur and Han groups.271cases among307were followed up completely, and the drop-out rate was11.73%. Univariate analysis with Kaplan-Meier method showed that there was statistically significant difference in disease-free survival(DFS) according to different factors, such as nationality, clinical staging, PR, primary tumor size, lymph node metastasis and molecular typing (Ps<0.05), but there was no significant difference in that of age, histological typing, ER, HER-2and Ki-67(P5>0.05). Multi-factors Cox regression analysis showed that only lymph node metastasis and molecular typing were risk indicators which could predict the prognosis of breast cancer. Conclusion:There was no significant difference in the constituent ratio of molecular typing of breast cancer between Uyghur and Han patients, but there was significant difference in the clinical feature between two ethnicities; Lynph noed metastasis and molecular subtypes can be choosed to the prognostic indicator of breast cancer and provide guidance for the clinical therapy.更多还原