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Analysis of Onset Characteristics and Clinical Features in Molecular Subtypes of Female Breast Cancer

Author: LiJing
Tutor: LiuJiWei
School: Dalian Medical University
Course: Oncology
Keywords: Breast cancer Molecular subtypes Clinical features
CLC: R737.9
Type: Master's thesis
Year: 2012
Downloads: 6
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Objective:Investigate the epidemiology and distribution of molecular subtypes ofbreast cancer,and its relationship of histological grade,tumor size,axillary lymph nodemetastasis,breast hyperplasia,blood types,it can provide an important basis for clinicaldiagnosis of breast cancer and guide the clinical treatment of breast cancer.Methods:This study included219consecutive patients with breast cancerdiagnosed in First Hospital of Dalian Medical University between January2011toDecember2011,who have precise clinical pathology and without any radiotherapy andchemotherapy before operation. According to the definitions used in prior studies, theimmunohistochemistry subtypes were as follows: Luminal A (ER+and/or PR+,HER-2-), Luminal B (ER+and/or PR+, HER-2+), HER-2+/ER-(ER-, PR-, andHER-2+), Basal-like (ER-, PR-, HER-2-, CK5/6+, and/or EGFR+), and unclassified.Investigate the epidemiology and the distribution of molecular subtypes of breastcancer,and the relationship of histological grade,tumor size,axillary lymph nodemetastasis,breast hyperplasia,blood types. Probe the characteristics and influence ofthe five types.Results:The occupancy of Luminal A, Luminal B, HER-2+/ER-, Basal-like, andunclassified in219patients are54.8%、6.9%、13.2%、12.8%and12.3%.There islower ratio of Luminal A in very young(<35years) patients than in less young(35~50years)patients (64%versus37.5%,P<0.001),and ratio of HER-2+/ER-and Basal-likein less young(35~50years)patients lower than older (>50years) patients and veryyoung(<35years) patients(5%versus25%,P=0.02;7%versus16%,P=0.027).Theseresults indicated that younger (≤50years) patients had a higher prevalence of ER+orPR+. Prevalence of ER+and PR+have a bearing on age,it has a higher expression in young patients than in older patients,but in the very young patients, it is lower thanyoung patients. Most breast cancer patients in the molecular subtypes of Basal-like arepostmenopausal, but also the postmenopausal age of them comes earlier. Luminal Atype of invasive non-special type carcinoma constitute higher than the other fourmolecular subtypes (P=0.008), and accounted for9cases in the whole11cases ofinvasive special type Carcinoma in this study,compared with breast cancer, in theinvasive particularity(82%). Tumor stage of Basal-like type compared with Luminal A,HER-2+/ER-and unclassified is early and have statistically significant (P=0.035,P=0.05, P=0.034). The lymph node positive rate in Basal-like type is smaller than othertypes, HER-2+/ER-of lymph node-positive rate and the number of metastatic is higherthan the other4types (P=0.025). There are19patients in Basal-like type of invasiveductal carcinoma grade III, it accounted for76%of Basal-like type in invasive ductalcarcinoma, poorly differentiated statistically significant (P <0.001). The ratio of breastcancer patients with breast hyperplasia is greater than the general population, thepatients of hyperplasia in younger patients constituent ratio is more than older patients,the patients with breast hyperplasia in HER-2+/ER-is less than other4types, Basal-liketype is the highest of all, and Luminal B type of bilateral breast hyperplasia constituentratio is the highest. There is no difference in blood type of5molecular subtypes, breastcancer patients compared with non-Type A blood, the composition breast cancerpopulation is high. The constituent ratio of breast cancer patients of blood group A isgreater than the general population.Conclusion:Luminal A prevalence is higher than other4types. Young breastcancer patients in Dalian are characterized by a high prevalence of Luminal A subtype,because constituent ratio of ER+and PR+in young breast cancer patients is higher thanolder patients, but in very young patients the ratio of ER+and PR+is lower than in lessyoung, these features are distinct from young breast cancer patients in western countries.In older group and a very young group of HER-2+/ER-and Basal-like type weresignificantly higher than the younger group, this is still related with the low ratio ofER+and PR+.Most breast cancer patients in the molecular subtypes of Basal-like arepostmenopausal, but also the postmenopausal age of them comes earlier,and theBasal-like type is less prone to occurred lymph node metastasis,but adverse histologicaldifferentiation, consider the estrogen receptor related with menopausal age andmetastasis,CK5/6and EGFR may lead tumor poorly differentiated. Breast hyperplasiais one of the predisposing factors of breast cancer, the expression of estrogen receptor positive and HER-2gene overexpression related with breast hyperplasia, butproliferation does not affect the stage.The women in blood type A compared with thewomen who is in O blood type is more prone to breast cancer, blood group antigenallele may exist with cancer gene and linked inheritance, resulting in blood type Opeople has a certain anti-cancer change.

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