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首页> 外文期刊>Cancer radiotherapie: journal de la Soci閠?fran鏰ise de radiotherapie oncologique >Are molecular subtypes and Ki67 expression predictors of locoregional relapse in breast cancer patients with negative lymph nodes after mastectomy: The Institut Curie-H?pital René-Huguenin experience and literature review [Valeur pronostique des sous-types moléculaires et du Ki67 pour les cancers du sein indemnes d'envahissement ganglionnaire après mastectomie: Expérience de l'institut Curie-h?pital René-Huguenin et revue de la littératur]
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Are molecular subtypes and Ki67 expression predictors of locoregional relapse in breast cancer patients with negative lymph nodes after mastectomy: The Institut Curie-H?pital René-Huguenin experience and literature review [Valeur pronostique des sous-types moléculaires et du Ki67 pour les cancers du sein indemnes d'envahissement ganglionnaire après mastectomie: Expérience de l'institut Curie-h?pital René-Huguenin et revue de la littératur]

机译：乳腺癌切除术后淋巴结阴性的乳腺癌患者的分子亚型和Ki67表达是否是局部复发的预测指标：Institut Curie-H？PitalRené-Huguenin经验和文献综述[分子亚型和Ki67对食管癌的预后价值乳房切除术后无淋巴结浸润的乳腺癌：René-Huguenin居里医院研究所的经验和文献复习]

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Purpose: To evaluate the prognostic value of Ki67 expression, breast cancer molecular subtypes and the impact of postmastectomy radiotherapy in breast cancer patients with pathologic negative lymph nodes (pN0) after modified radical mastectomy. Patients and methods: Six hundred and ninety-nine breast cancer patients with pN0 status after modified radical mastectomy, treated between 2001 and 2008, were identified from a prospective database in a single institution. Tumours were classified by intrinsic molecular subtype as luminal A or B, HER2+, and triple-negative using estrogen, progesterone, and HER2 receptors. Multivariate Cox analysis was used to determine the risk of locoregional recurrence associated with intrinsic subtypes and Ki67 expression, adjusting for known prognostic factors. Results: At a median follow-up of 56. months, 17 patients developed locoregional recurrence. Five-year locoregional recurrence-free survival and overall survival in the entire population were 97%, and 94.7%, respectively, with no difference between the postmastectomy radiotherapy (n=191) and no-postmastectomy radiotherapy (n=508) subgroups. No constructed subtype was associated with an increased risk of locoregional recurrence. A Ki67 above 20% was the only independent prognostic factor associated with increased locoregional recurrence (hazard ratio, 4.18; 95% CI, 1.11 to 15.77; P<. 0.0215). However, postmastectomy radiotherapy was not associated with better locoregional control in patients with proliferative tumours. Conclusion: Ki67 expression but not molecular subtypes are predictors of locoregional recurrence in breast cancer patients with negative lymph nodes after modified radical mastectomy. The benefit of adjuvant radiotherapy in patients with proliferative tumours should be further investigated in prospective studies.
机译：目的：评估改良的根治性乳房切除术后病理阴性的乳腺癌患者中Ki67表达，乳腺癌分子亚型以及乳腺癌切除术后放疗对预后的影响。患者和方法：从一所机构的前瞻性数据库中，鉴定出2001年至2008年之间接受治疗的699例经改良根治性乳房切除术后处于pN0状态的乳腺癌患者。使用雌激素，孕酮和HER2受体将肿瘤按内在分子亚型分类为腔A或B，HER2 +和三阴性。多变量Cox分析用于确定与内在亚型和Ki67表达相关的局部复发的风险，并调整已知的预后因素。结果：在56个月的中位随访中，有17例患者发生局部复发。整个人群的五年局部无复发生存率和总生存率分别为97％和94.7％，乳房切除术后放疗（n = 191）和非乳房切除术后放疗（n = 508）亚组之间没有差异。没有构建亚型与局部复发风险增加相关。 Ki67高于20％是与局部复发增加相关的唯一独立预后因素（危险比为4.18; 95％CI为1.11至15.77; P <0.0215）。然而，对于有增生性肿瘤的患者，乳房切除术后放疗与更好的局部区域控制无关。结论：Ki67表达而非分子亚型是乳腺癌改良根治术后淋巴结阴性的局部复发的指标。在前瞻性研究中应进一步研究辅助放疗对增生性肿瘤患者的益处。

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