乳腺癌整形和器官保留手术后的局部复发

O. N. Ganusevich, T. N. Nesterovich, I. V. Fedarkevich, S. L. Achinovich, D. M. Los’, I. V. Kontsevenko
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In order to statistically assess the relationship between the frequency of relapses depending on the stage and the molecular biological type of neoplasm, the Spearman correlation coeffi cient was used. The accepted level of statistical signifi cance (p) was 0.05.Results. Locoregional relapses were recorded in 11 (3.6%) patients, of which local — in 8 (2.6%), regional — in 3 (1.0%). The minimum period of development of LRR was 15 months, the maximum was 74 months; the median period of occurrence of LRR was 47 months. Depending on the stage of breast cancer, relapses developed: at stage I — in 4 (3.7%) cases, II — 5 (3.5%), III — 2 (4.2%). Depending on the molecular biological subtype of the neoplasm, LRR were distributed as follows: with luminal A — 1 (1.3%) case, luminal In HER2-negative — 1 (0.9%), luminal In HER2-positive — 6 (9.7%), non-luminal HER2-positive 1 (6.3%), three times negative — 2 (5.6%). 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引用次数: 0

摘要

目的分析乳腺癌(BC)整形和器官保留手术后的局部区域复发(LRR)。对2014年至2019年期间在戈梅利地区临床肿瘤医院普通肿瘤学和康复肿瘤科接受整形和保留器官手术的303名乳腺癌患者的治疗结果进行了回顾性分析。中位年龄为 44 岁(25-70 岁)。统计数据的处理使用 10.0 版应用软件 "Statistica "进行。为了描述被调查群体的特征,采用了基于描述性统计数据计算的标准方法。为了统计评估复发频率与肿瘤分期和分子生物学类型之间的关系,使用了斯皮尔曼相关系数。统计意义(p)的公认水平为 0.05。有 11 例(3.6%)患者出现局部复发,其中 8 例(2.6%)为局部复发,3 例(1.0%)为区域复发。复发的最短时间为 15 个月,最长时间为 74 个月;复发的中位时间为 47 个月。根据乳腺癌的分期,复发情况如下:I期--4例(3.7%),II期--5例(3.5%),III期--2例(4.2%)。根据肿瘤的分子生物学亚型,LRR 的分布情况如下:腔内 A 型--1 例(1.3%),腔内 HER2 阴性--1 例(0.9%),腔内 HER2 阳性--6 例(9.7%),非腔内 HER2 阳性 1 例(6.3%),三次阴性--2 例(5.6%)。8例(72.7%)复发性肿瘤患者的受体状态不一致,最常见的原因是孕酮受体(PR)丢失或减少。原发性肿瘤中的肿瘤淋巴细胞(TILs)水平在4%至12%之间,而复发性肿瘤中的TILs水平仍然很低:5%至10%。鉴于 BC 的异质性,发生 LRR 的风险取决于很多因素。9.7%的管腔型HER2阳性乳腺癌(P 0.05)、III期乳腺癌--4.2%(P 0.05)发生LRR。TILs的评估是重要的预测因素之一。我们注意到,原发性和复发性肿瘤中的 TILs 水平都很低。受体状态的不一致性很高--72.7%,这一点在开具系统治疗处方时必须考虑到。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Locoregional recurrences of breast cancer after reconstructive plastic and organ-preserving surgery
Objective. To analyze locoregional relapses (LRR) after reconstructive plastic and organ-preserving operations in breast cancer (BC)Materials and methods. A retrospective analysis of the results of the treatment of 303 patients with BC who underwent reconstructive plastic and organ-preserving operations in the period from 2014 to 2019 in the Oncological Department of General Oncology and Rehabilitation of Gomel Regional Clinical Oncological Dispensary was carried out. The median age was 44 years (25-70 years). Statistical data processing was carried out using the application software package “Statistica”, 10.0. To characterize the surveyed groups, a standard methodological approach based on the calculation of descriptive statistics data was used. In order to statistically assess the relationship between the frequency of relapses depending on the stage and the molecular biological type of neoplasm, the Spearman correlation coeffi cient was used. The accepted level of statistical signifi cance (p) was 0.05.Results. Locoregional relapses were recorded in 11 (3.6%) patients, of which local — in 8 (2.6%), regional — in 3 (1.0%). The minimum period of development of LRR was 15 months, the maximum was 74 months; the median period of occurrence of LRR was 47 months. Depending on the stage of breast cancer, relapses developed: at stage I — in 4 (3.7%) cases, II — 5 (3.5%), III — 2 (4.2%). Depending on the molecular biological subtype of the neoplasm, LRR were distributed as follows: with luminal A — 1 (1.3%) case, luminal In HER2-negative — 1 (0.9%), luminal In HER2-positive — 6 (9.7%), non-luminal HER2-positive 1 (6.3%), three times negative — 2 (5.6%). Discordance of the receptor status was detected in 8 (72.7%) patients with recurrent tumor, most often due to the loss or decrease in the number of progesterone receptors (PR). The level of tumor-infi ltrating lymphocytes (TILs) in primary neoplasm ranged from 4 to 12%, in recurrent tumors it remained low: 5-10%.Conclusion. Given the heterogeneity of BC, the risk of developing LRR depends on many factors. LRR developed in luminal HER2-positive cancer in 9.7% of cases (p 0.05), stage III breast cancer — 4.2% (p 0.05). One of the important predictive factors is the evaluation of TILs. We noted a low level of TILs in both primary and recurrent tumors. There is a high discordance in the receptor status — 72.7%, which is important to take into account when prescribing systemic therapy.
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