三阴性乳腺癌中PIK3CA基因状态与临床特征及预后的关系

国际肿瘤学杂志››2023,Vol. 50››Issue (5): 263-267.doi:10.3760/cma.j.cn371439-20230310-00053

三阴性乳腺癌中PIK3CA基因状态与临床特征及预后的关系

李彬¹, 张桂芳²(), 周林静², 杨小冬², 何秋立², 贾思思², 黄普超², 梁嘉欣¹

¹新乡医学院第四临床学院，新乡 453000
²河南省新乡市中心医院东院区肿瘤内科，新乡 453000

收稿日期:2023-03-10修回日期:2023-04-12出版日期:2023-05-08发布日期:2023-06-27
通讯作者:张桂芳 E-mail:xxchzhangguifang@126.com
基金资助:
河南省新乡市科技攻关项目(GG2019027)

Relationships between PIK3CA gene status and clinical features and prognosis in triple-negative breast cancer

Li Bin¹, Zhang Guifang²(), Zhou Linjing², Yang Xiaodong², He Qiuli², Jia Sisi², Huang Puchao², Liang Jiaxin¹

¹The Fourth Clinical College， Xinxiang Medical University， Xinxiang 453000， China
²Department of Oncology， East Hospital of Xinxiang Central Hospital of Henan Province， Xinxiang 453000， China

Received:2023-03-10Revised:2023-04-12Online:2023-05-08Published:2023-06-27
Contact:Zhang Guifang E-mail:xxchzhangguifang@126.com
Supported by:
Science and Technology Project of Xinxiang of Henan Province(GG2019027)

摘要/Abstract

摘要：

目的检测三阴性乳腺癌（TNBC）组织中的PIK3CA状态，分析PIK3CA突变与临床特征的关系及对预后的影响。方法收集2016年1月1日至2018年12月31日河南省新乡市中心医院收治的原发性TNBC患者50例，检测肿瘤组织PIK3CA突变状态，分析PIK3CA突变与TNBC患者临床特征的关系及对预后的影响。结果50例TNBC患者中，检测到PIK3CA基因突变9例，突变频率18.0%；其中H1047R突变4例，E545K突变3例，E542K突变2例。PIK3CA基因突变与年龄（χ²=3.55，P=0.060）、肿瘤部位（χ²=1.01，P=0.315）、肿瘤大小（χ²<0.01，P>0.999）、淋巴结状态（χ²=0.76，P=0.385）、临床分期（χ²=0.65，P=0.420）、Ki-67值（χ²<0.01，P>0.999）、P53状态（χ²=0.02，P=0.894）以及人表皮生长因子受体-2（HER-2）状态（χ²=1.65，P=0.200）均无明显相关性。预后分析显示，PIK3CA野生型患者的3年无瘤生存率显著高于突变型患者（80.5%比11.1%，χ²=28.23，P<0.001）。结论TNBC患者的PIK3CA基因突变频率较高，TNBC患者PIK3CA突变与临床病理特征均无相关性，PIK3CA基因突变可能与TNBC不良预后显著相关。

关键词:三阴性乳腺癌,PIK3CA基因突变,预后

Abstract:

ObjectiveTo detect the status of PIK3CA in triple-negative breast cancer （TNBC）， and to analyze the relationships between PIK3CA mutation and clinical features and its impact on prognosis.MethodsFrom January 1， 2016 to December 31， 2018， 50 patients with primary TNBC admitted to Xinxiang Central Hospital of Henan Province were collected. The PIK3CA mutation status was detected， and the relationships between PIK3CA mutation and clinical characteristics of patients with TNBC and its impact on prognosis were analyzed.ResultsPIK3CA gene mutation was detected in 9 of 50 TNBC patients， with a mutation frequency of 18.0%. H1047R mutation was found in 4 cases， E545K mutation in 3 cases and E542K mutation in 2 cases. PIK3CA gene mutation was not associated with age （χ²=3.55，P=0.060）， tumor location （χ²=1.01，P=0.315）， tumor size （χ²<0.01，P>0.999）， lymph node status （χ²=0.76，P=0.385）， clinical stage （χ²=0.65，P=0.420）， Ki-67 value （χ²<0.01，P>0.999）， P53 status （χ²=0.02，P=0.894） and human epidermal growth factor receptor-2 （HER-2） status （χ²=1.65，P=0.200）. Prognostic analysis showed that 3-year disease-free survival rates of wild-type PIK3CA patients was significantly higher than that of mutant PIK3CA patients （80.5%vs.11.1%，χ²=28.23，P<0.001）.ConclusionThe frequency of PIK3CA gene mutation is higher in TNBC patients. There is no correlation between PIK3CA mutation and clinicopathologic features in TNBC patients. PIK3CA gene mutation may be significantly associated with poor prognosis of TNBC patients.

Key words:Triple negative breast cancer,PIK3CA gene mutation,Prognosis

李彬, 张桂芳, 周林静, 杨小冬, 何秋立, 贾思思, 黄普超, 梁嘉欣. 三阴性乳腺癌中PIK3CA基因状态与临床特征及预后的关系[J]. 国际肿瘤学杂志, 2023, 50(5): 263-267.

Li Bin, Zhang Guifang, Zhou Linjing, Yang Xiaodong, He Qiuli, Jia Sisi, Huang Puchao, Liang Jiaxin. Relationships between PIK3CA gene status and clinical features and prognosis in triple-negative breast cancer[J]. Journal of International Oncology, 2023, 50(5): 263-267.

图/表3

表1

50例三阴性乳腺癌患者的临床特征"

临床特征	例数	百分比（%）
初诊年龄（岁）
≤50	28	56.0
>50	22	44.0
肿瘤位置
左乳	27	54.0
右乳	23	46.0
肿瘤组织学
浸润性导管癌	43	86.0
导管原位癌	1	2.0
浸润性小叶癌	2	4.0
其他	4	8.0
T分期
T₁	24	48.0
T₂	26	52.0
N分期
N₀	26	52.0
N₁	17	34.0
N₂	6	12.0
N₃	1	2.0
临床分期
Ⅰ	13	26.0
Ⅱ	30	60.0
Ⅲ	7	14.0
肿瘤大小（cm）
≤2	16	32.0
>2	34	68.0
淋巴结状态
转移	24	48.0
无转移	26	52.0
P53状态
-	26	52.0
+	24	48.0
Ki-67值
≤20%	14	28.0
>20%	36	72.0
HER-2状态
-	29	58.0
+	16	32.0
++	5	10.0

表1

表2

三阴性乳腺癌中PIK3CA基因突变与临床特征的关系（例）"

临床特征	例数	PIK3CA		χ²值	P值
临床特征	例数	野生型	突变型	χ²值	P值
年龄（岁）
≤50	28	26	2	3.55	0.060
>50	22	15	7	3.55	0.060
肿瘤部位
左乳	27	24	3	1.01	0.315
右乳	23	17	6	1.01	0.315
肿瘤大小（cm）
≤2	16	13	3	<0.01	>0.999
>2	34	28	6	<0.01	>0.999
淋巴结状态
无转移	26	23	3	0.76	0.385
转移	24	18	6	0.76	0.385
临床分期
Ⅰ~Ⅱ期	43	34	9	0.65	0.420
Ⅲ期	7	7	0	0.65	0.420
Ki-67值
≤20%	14	11	3	<0.01	>0.999
>20%	36	30	6	<0.01	>0.999
P53状态
-	26	22	4	0.02	0.894
+	24	19	5	0.02	0.894
HER-2状态
阴性	29	26	3	1.65	0.200
低表达	21	15	6	1.65	0.200

表2

图1

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