目的本研究旨在确定在国家癌症研究所(INCan)接受治疗的西班牙裔墨西哥乳腺癌(BC)患者队列中内分泌抵抗的患病率。此外,确定了与内分泌抵抗相关的临床病理因素,并探讨了它们对患者生存的影响。方法回顾性分析2012年至2016年间200例接受INCan治疗的雌激素受体(ER)和孕激素受体(PR)阳性肿瘤患者的临床资料。根据《乳腺癌进展国际共识指南2》的定义对内分泌耐药进行了定义。分析其临床病理特征,以确定与内分泌抵抗的存在。我们使用了敏感性分析和多变量调整逻辑回归,卡普兰-迈耶曲线,和多变量调整后的Cox回归。P值<0.05被认为具有统计学意义。结果32.5%的患者出现内分泌耐药。激素抵抗和敏感性之间的区别受肿瘤大小和淋巴结状态的影响。内分泌抵抗病例的平均直径为7.15cm,而非内分泌病例的平均直径为5.71cm,在20%的内分泌抵抗病例中存在N3状态,而在非内分泌病例中只有2.2%(p值<0.001)。临床分期与内分泌抵抗密切相关(风险比[RR]4.39,95%置信区间[95CI]1.50,11.43)。此外,内分泌抵抗显著影响随访期间的死亡率,在多变量调整模型中,危险比[HR]为23.7(95CI5.20,108.42)。然而,一个完整的病理反应降低了内分泌抵抗的风险,风险比(RR)为0.15(95%CI0.03,0.75)。结论西班牙裔墨西哥BC患者诊断为晚期临床分期可预测内分泌抵抗。局部晚期疾病患者的完全病理反应也是内分泌抵抗的关键预测因子。这些结果表明,内分泌抵抗是随访期间BC的关键因素。
UNASSIGNED: This study aimed to determine the prevalence of endocrine resistance in a cohort of Hispanic Mexican breast cancer (BC) patients receiving care at Instituto Nacional de Cancerología (INCan). Additionally, the clinical-pathological factors associated with endocrine resistance were identified, and their impact on patient survival was explored.
UNASSIGNED: A retrospective analysis of 200 BC patients who attended INCan between 2012 and 2016 with estrogen receptor (ER) and progesterone receptor (PR) positive tumors was made. Endocrine resistance was defined according to the International Consensus Guidelines for Advance Breast Cancer 2 definition. Their clinicopathological characteristics were analyzed to determine the association with endocrine resistance presence. We used sensitivity analyses and multivariate-adjusted logistic regressions, Kaplan-Meier curves, and multivariate-adjusted Cox regressions. P-value < 0.05 was considered as statistically significant.
UNASSIGNED: Endocrine resistance was observed in 32.5% of patients included in this study. The distinction between hormone resistance and sensitivity was influenced by tumor size and node status. It had a mean diameter of 7.15 cm in endocrine resistance cases compared to 5.71 cm in non-endocrine, with N3 status present in 20% of endocrine resistance cases versus only 2.2% in non-endocrine (p-value < 0.001). The clinical stage exhibited a strong association with endocrine resistance (Risk Ratio [RR] 4.39, 95% confidence interval [95%CI] 1.50, 11.43). Furthermore, endocrine resistance significantly impacted mortality during the follow-up, with a Hazard Ratio [HR] of 23.7 (95%CI 5.20, 108.42) in multivariable-adjusted models. However, a complete pathological response reduced the endocrine resistance risk, as demonstrated by a Risk Ratio (RR) of 0.15 (95% CI 0.03, 0.75).
UNASSIGNED: Advanced clinical stage at diagnosis predicted endocrine resistance in Hispanic Mexican BC patients. Complete pathologic response in locally advanced disease patients was also a key predictor of endocrine resistance. These results indicated that endocrine resistance was a critical factor in BC during follow-up.