Correlation between lymph node metastasis ratio and prognosis of breast cancer with different molecular subtypes / 中国肿瘤生物治疗杂志

ABSTRACT

@# Objective: To discuss the relationship between lymph node metastasis rate and the prognosis of patients with stage II and III breast cancer with different molecular subtypes. Methods: The clinical data of 311 patients diagnosed with stage II and III breast cancer, who received preferred surgical treatment in Changzhou Second People's Hospital Affiliated to Nanjing Medical University from January 2011 to January 2016, were retrospectively analyzed. According to the levels of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2) and Ki-67 proliferation index, the patients were divided into four groups, namely, Luminal A, Luminal B, HER2 over-expression and triple negative breast cancer (TNBC). Chi-square test was used to analyze the clinical characteristics of patients in different groups. Kaplan-Meier survival curve was used to evaluate the prognostic impact of axillary lymph node metastasis rate (LNR) on patients with different types of breast cancer, and the prognostic differences among breast cancer patients with different molecular subtypes under the same LNR. Spearman correlation was used to analyze the correlation between LNR and Ki-67 proliferation index. Results: There were no significant differences in clinical characteristics of age, menopause, tumor size, lymph node status and metastasis site among BC patients with different molecular subtypes (all P>0.05). There was no significant difference in disease-free survival (DFS) among the four subgroups with LNR of 0 or >0.65 (χ2=3.581, 2.808, all P>0.05); and there was significant difference in DFS among the four subgroups with LNR between 0.01 and 0.65 (χ2=24.366, 8.169, all P<0.05). LNR was positively correlated with the Ki-67 proliferation index (r=0.125, P<0.05). Multivariate Cox regression analysis showed that the prognosis of breast cancer patients was related to molecular subtypes (RR=1.179, 95%CI=1.023-1.358; χ2=5.165, P<0.05), LNR (RR =1.137, 95%CI=0.985-0.999; χ2=5.589, P<0.05) and Ki-67 proliferation index (RR=0.992, 95%CI=1.022-1.264; χ2=5.623， P<0.05). Conclusion: LNR is an important prognostic factor for stage II and III breast cancer. With the same LNR, the prognosis of breast cancer patients with different molecular subtypes varies greatly. LNR is positively correlated with Ki-67 proliferation index.