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目的对肿瘤激素受体表达状态作为乳腺癌转移的一项预后指标进行评价。资料与方法根据转移方式对转移性乳腺癌患者进行分组,将57例雌激素受体(ER)和孕激素受体(PR)情况(ER+或ER-/PR+或PR-)已知的转移性乳腺癌患者纳入研究,并行脑MRI和全身骨核素扫描(ECT)等影像学检查。结果28例患者发生骨转移无脑转移,57%的患者ER+/PR+。7例患者有脑转移无骨转移,71%(5/7)的患者ER-/PR-。10例患者发生骨转移无脑转移且有其他部位的转移。12例患者向脑、内脏、骨广泛转移,无ER+/PR-。以上四组ER和PR表达状态间差异有统计学意义。结论除了广泛转移组,转移性乳腺癌主要有两种转移方式。ER+/PR+的乳腺癌更容易发生骨转移。ER-/PR-的乳腺癌容易发生脑转移而不易发生骨转移。对其的认知有利于指导放射科医师对转移病灶的检出并帮助临床医师估计乳腺癌转移至各个脏器系统的可能性,同时指导对其进行靶向预防性治疗。
Objective To assess the expression of tumor hormone receptors as a prognostic indicator of breast cancer metastasis. Materials and Methods Metastatic breast cancer patients were grouped according to metastatic patterns and metastatic rates were known for 57 cases of estrogen receptor (ER) and progesterone receptor (PR) conditions (ER + or ER- / PR + or PR-) Breast cancer patients included in the study, concurrent brain MRI and whole body radionuclide scan (ECT) and other imaging studies. Results 28 cases of patients with bone metastases without brain metastases, 57% of patients with ER + / PR +. Seven patients had brain metastases without bone metastases, and 71% (5/7) had ER- / PR-. Ten patients developed bone metastases without brain metastases and had other sites of metastases. Twelve patients had extensive metastases to brain, internal organs and bone without ER + / PR-. There was significant difference between the above four groups in the expression of ER and PR. Conclusion In addition to the extensive metastasis group, there are mainly two types of metastases in metastatic breast cancer. Breast cancer is more prone to bone metastasis in ER + / PR +. ER- / PR- breast cancer prone to brain metastases and less prone to bone metastases. Its cognition is conducive to guide the radiologist in the detection of metastatic lesions and help clinicians to estimate the possibility of breast cancer metastasizing to various organ systems, and at the same time guide the targeted preventive therapy.