Journal of Surgery Concepts & Practice ›› 2022, Vol. 27 ›› Issue (05): 421-428.doi: 10.16139/j.1007-9610.2022.05.009
• Original article • Previous Articles Next Articles
YANG Cuiyan, WANG Haoyu, CHEN Xiaosong(), SHEN Kunwei(
)
Received:
2022-08-30
Online:
2022-09-25
Published:
2022-11-10
Contact:
CHEN Xiaosong,SHEN Kunwei
E-mail:chenxiaosong0156@hotmail.com;kwshen@medmail.com.cn
CLC Number:
YANG Cuiyan, WANG Haoyu, CHEN Xiaosong, SHEN Kunwei. Study on tumour suppressor gene TP53 mutation and prognosis in patients with triple-negative breast cancer[J]. Journal of Surgery Concepts & Practice, 2022, 27(05): 421-428.
标准 | 描述 |
---|---|
致病性 | (i)1个非常强(PVS1)和 |
(a)≥1个强(PS1-PS4)或 | |
(b)≥2个中等(PM1-PM6)或 | |
(c)1个中等(PM1-PM6)和1个支持(PP1-PP5)或 | |
(d)≥2个支持(PP1-PP5) | |
(ii)≥2个强(PS1-PS4)或 | |
(iii)1个强(PS1)和 | |
(a)≥3个中等(PM1-PM6)或 | |
(b)2个中等(PM1-PM6)和≥2个支持(PP1-PP5)或 | |
(c)1个中等(PM1-PM6)和≥4个支持(PP1-PP5) | |
可能致病性 | (i)1个非常强(PVS1)和1个中等(PM1-PM6)或 |
(ii)1个强(PS1-PS4)和1-2个中等(PM1-PM6)或 | |
(iii)1个强(PS1-PS4)和≥2个支持(PP1-PP5)或 | |
(iv)≥3个中等(PM1-PM6)或 | |
(v)2个中等(PM1-PM6)和≥2个支持(PP1-PP5)或 | |
(vi)1个中等(PM1-PM6)和≥4个支持(PP1-PP5) |
项目 | 总人数 (n=234) | TP53突变 (n=144) | TP53野生型 (n=90) | P值 |
---|---|---|---|---|
年龄(岁) | 0.162 | |||
≤50 | 101(43.16) | 57(39.58) | 44(48.89) | |
>50 | 133(56.84) | 87(60.42) | 46(51.11) | |
月经状态 | 0.417 | |||
绝经前/ 围绝经期 | 104(44.44) | 61(42.36) | 43(47.78) | |
绝经后 | 130(55.56) | 83(57.64) | 47(52.22) | |
新辅助化疗 | 0.079 | |||
无 | 197(84.19) | 126(87.50) | 71(78.89) | |
有 | 37(15.81) | 18(12.50) | 19(21.11) | |
肿瘤长径(cm) | 0.491 | |||
≤2.0 | 100(42.74) | 59(40.97) | 41(45.56) | |
>2.0 | 134(57.26) | 85(59.03) | 49(54.44) | |
淋巴结状态 | 0.739 | |||
阴性 | 132(56.41) | 80(55.56) | 52(57.78) | |
阳性 | 102(43.59) | 64(44.44) | 38(42.22) | |
病理类型 | 0.246 | |||
导管癌 | 205(87.61) | 129(89.58) | 76(84.44) | |
非导管癌 | 29(12.39) | 15(10.42) | 14(15.56) | |
组织学分级 | 0.013 | |||
Ⅰ/Ⅱ | 62(26.50) | 30(20.83) | 32(35.56) | |
Ⅲ | 172(73.50) | 114(79.17) | 58(64.44) | |
Ki-67(%) | 0.004 | |||
≤30 | 61(26.07) | 28(19.44) | 33(36.67) | |
>30 | 173(73.93) | 116(80.56) | 57(63.33) | |
脉管癌栓 | 0.196 | |||
阴性 | 202(86.32) | 121(84.03) | 81(90.00) | |
阳性 | 32(13.68) | 23(15.97) | 9(10.00) | |
手术方式 | 0.209 | |||
保乳 | 82(35.04) | 46(31.94) | 36(40.00) | |
单纯切除 | 152(64.96) | 98(68.06) | 54(60.00) | |
化疗 | 1.000 | |||
无 | 8(3.42) | 5(3.47) | 3(3.33) | |
有 | 226(96.58) | 139(96.53) | 87(96.67) | |
铂类药物 | 0.363 | |||
无 | 118(50.43) | 76(52.78) | 42(46.67) | |
有 | 116(49.57) | 68(47.22) | 48(53.33) | |
放疗 | 0.372 | |||
无 | 73(31.20) | 48(33.33) | 25(27.78) | |
有 | 161(68.80) | 96(66.67) | 65(72.22) | |
结局 | 0.598 | |||
无转移/复发 | 171(73.08) | 106(73.61) | 65(72.22) | |
局部复发 | 30(12.82) | 20(13.89) | 10(11.11) | |
远处转移 | 33(14.10) | 18(12.50) | 15(16.67) | |
HRR突变 | 0.495 | |||
无 | 179(76.50) | 108(75.00) | 71(78.89) | |
有 | 55(23.50) | 36(25.00) | 19(21.11) |
项目 | TP53突变 (n=144) | 错义突变 (n=85) | 非错义突变 (n=59) | P值 |
---|---|---|---|---|
年龄(岁) | 0.902 | |||
≤50 | 57(39.58) | 34(40.00) | 23(38.98) | |
>50 | 87(60.42) | 51(60.00) | 36(61.02) | |
月经状态 | 0.730 | |||
绝经前/ 围绝经期 | 61(42.36) | 35(41.18) | 26(44.07) | |
绝经后 | 83(57.64) | 50(58.82) | 33(55.93) | |
肿瘤长径(cm) | 0.776 | |||
≤2.0 | 59(40.97) | 34(40.00) | 25(42.37) | |
>2.0 | 85(59.03) | 51(60.00) | 34(57.63) | |
淋巴结状态 | 0.150 | |||
阴性 | 80(55.56) | 43(50.59) | 37(62.71) | |
阳性 | 64(44.44) | 42(49.41) | 22(37.29) | |
病理类型 | 0.113 | |||
导管癌 | 129(89.58) | 79(92.94) | 50(84.75) | |
非导管癌 | 15(10.42) | 6(7.06) | 9(15.25) | |
组织学分级 | 0.073 | |||
Ⅰ/Ⅱ | 30(20.83) | 22(25.88) | 8(13.56) | |
Ⅲ | 114(79.17) | 63(74.12) | 51(86.44) | |
Ki-67(%) | 0.290 | |||
≤30 | 28(19.44) | 19(22.35) | 9(15.25) | |
>30 | 116(80.56) | 66(77.65) | 50(84.75) | |
脉管癌栓 | 0.845 | |||
阴性 | 121(84.03) | 71(83.53) | 50(84.75) | |
阳性 | 23(15.97) | 14(16.47) | 9(15.25) | |
结局 | 0.458 | |||
无复发/转移 | 171(73.08) | 60(70.59) | 46(77.97) | |
局部复发 | 30(12.82) | 12(14.12) | 8(13.56) | |
远处转移 | 33(14.10) | 13(15.29) | 5(8.47) | |
HRR突变 | 0.379 | |||
无 | 108(75.00) | 66(77.65) | 42(71.19) | |
有 | 36(25.00) | 19(22.35) | 17(28.81) |
项目 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
HR | 95% CI | P值 | HR | 95% CI | P值 | ||
TP53突变 | 0.83 | 0.52~1.33 | 0.445 | 0.67 | 0.41~1.08 | 0.102 | |
年龄 | 1.71 | 1.05~2.79 | 0.032 | 2.06 | 1.25~3.39 | 0.005 | |
月经 | 1.48 | 0.92~2.38 | 0.110 | NA | NA | NA | |
肿瘤大小 | 2.48 | 1.47~4.19 | 0.001 | 2.11 | 1.23~3.61 | 0.007 | |
淋巴结状态 | 3.07 | 1.90~4.96 | <0.001 | 2.48 | 1.49~4.13 | <0.001 | |
病理 | 1.36 | 0.62~2.96 | 0.443 | NA | NA | NA | |
组织学分级 | 1.04 | 0.62~1.74 | 0.879 | NA | NA | NA | |
Ki-67 | 0.77 | 0.47~1.26 | 0.294 | NA | NA | NA | |
脉管癌栓 | 3.24 | 1.89~5.54 | <0.001 | 2.42 | 1.34~4.38 | 0.003 | |
HRR突变 | 0.70 | 0.39~1.25 | 0.227 | NA | NA | NA |
项目 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
HR | 95% CI | P值 | HR | 95% CI | P值 | ||
TP53突变 | 0.59 | 0.33~1.08 | 0.087 | 0.49 | 0.27~0.90 | 0.022 | |
年龄 | 1.33 | 0.71~2.47 | 0.370 | NA | NA | NA | |
月经 | 1.80 | 0.95~3.41 | 0.072 | NA | NA | NA | |
肿瘤大小 | 2.76 | 1.36~5.61 | 0.005 | 2.12 | 1.02~4.41 | 0.044 | |
淋巴结状态 | 6.09 | 2.92~12.71 | <0.001 | 5.43 | 2.54~11.60 | <0.001 | |
病理 | 1.33 | 0.47~3.71 | 0.592 | NA | NA | NA | |
组织学分级 | 1.02 | 0.52~2.00 | 0.946 | NA | NA | NA | |
Ki-67 | 0.79 | 0.42~1.51 | 0.477 | NA | NA | NA | |
脉管癌栓 | 2.36 | 1.16~4.80 | 0.018 | 1.21 | 0.57~2.56 | 0.616 | |
HRR突变 | 0.84 | 0.40~1.75 | 0.635 | NA | NA | NA |
项目 | 单因素分析 | 多因素分析 | |||||
---|---|---|---|---|---|---|---|
HR | 95% CI | P值 | HR | 95% CI | P值 | ||
TP53突变 | 0.63 | 0.35~1.15 | 0.134 | 0.54 | 0.30~0.99 | 0.047 | |
年龄 | 1.48 | 0.79~2.78 | 0.218 | NA | NA | NA | |
月经 | 1.60 | 0.85~3.00 | 0.143 | NA | NA | NA | |
肿瘤大小 | 3.67 | 1.70~7.91 | 0.001 | 3.08 | 1.42~6.69 | 0.005 | |
淋巴结状态 | 4.67 | 2.35~9.28 | <0.001 | 4.13 | 2.07~8.26 | <0.001 | |
病理 | 1.39 | 0.49~3.88 | 0.535 | NA | NA | NA | |
组织学分级 | 0.87 | 0.45~1.67 | 0.677 | NA | NA | NA | |
Ki-67 | 0.93 | 0.48~1.82 | 0.835 | NA | NA | NA | |
脉管癌栓 | 1.81 | 0.83~3.92 | 0.133 | NA | NA | NA | |
HRR突变 | 0.51 | 0.21~1.20 | 0.122 | NA | NA | NA |
[1] | Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3):209-249. |
[2] | Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer[J]. N Engl J Med, 2010, 363(20):1938-1948. |
[3] | Dent R, Trudeau M, Pritchard KI, et al. Triple-negative breast cancer: clinical features and patterns of recurrence[J]. Clin Cancer Res, 2007, 13( <W>15 Pt 1):4429-4434. |
[4] | Cancer Genome Atlas Network. Comprehensive molecular portraits of human breast tumours[J]. Nature, 2012, 490(7418):61-70. |
[5] | Boyarskikh UA, Gulyaeva LF, Avdalyan AM, et al. Spectrum of TP53 mutations in BRCA1/2 associated high-grade serous ovarian cancer[J]. Front Oncol, 2020, 10:1103. |
[6] | Shahbandi A, Nguyen HD, Jackson JG. TP53 mutations and outcomes in breast cancer: reading beyond the headlines[J]. Trends Cancer, 2020, 6(2):98-110. |
[7] | Hammond ME, Hayes DF, Dowsett M, et al. American Society of Clinical Oncology; College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version)[J]. Arch Pathol Lab Med, 2010, 134(7):e48-e72. |
[8] | Wolff AC, Hammond MEH, Allison KH, et al. Human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update[J]. J Clin Oncol, 2018, 36(20):2105-2122. |
[9] | Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging[J]. CA Cancer J Clin, 2017, 67(2):93-99. |
[10] | Richards S, Aziz N, Bale S, et al. ACMG Laboratory Quality Assurance Committee. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology[J]. Genet Med, 2015, 17(5):405-424. |
[11] | Tolaney SM, Garrett-Mayer E, White J, et al. Updated standardized definitions for efficacy end points (STEEP) in adjuvant breast cancer clinical trials: STEEP version 2.0[J]. J Clin Oncol, 2021, 39(24):2720-2731. |
[12] | Basho RK, de Melo Gagliato D, Ueno NT, et al. Clinical outcomes based on multigene profiling in metastatic breast cancer patients[J]. Oncotarget, 2016, 7(47):76362-76373. |
[13] | Dumay A, Feugeas JP, Wittmer E, et al. Distinct tumor protein p53 mutants in breast cancer subgroups[J]. Int J Cancer, 2013, 132(5):1227-1231. |
[14] | Bae SY, Nam SJ, Jung Y, et al. Differences in prognosis and efficacy of chemotherapy by p53 expression in triple-negative breast cancer[J]. Breast Cancer Res Treat, 2018, 172(2):437-444. |
[15] | Olivier M, Langerød A, Carrieri P, et al. The clinical value of somatic TP53 gene mutations in 1,794 patients with breast cancer[J]. Clin Cancer Res, 2006, 12(4):1157-1167. |
[16] | Pollock NC, Ramroop JR, Hampel H, et al. Differences in somatic TP53 mutation type in breast tumors by race and receptor status[J]. Breast Cancer Res Treat, 2022, 192(3):639-648. |
[17] | Alexandrova EM, Mirza SA, Xu S, et al. p53 loss-of-heterozygosity is a necessary prerequisite for mutant p53 stabilization and gain-of-function in vivo[J]. Cell Death Dis, 2017, 8(3):e2661. |
[18] | Hassin O, Nataraj NB, Shreberk-Shaked M, et al. Diffe-rent hotspot p53 mutants exert distinct phenotypes and predict outcome of colorectal cancer patients[J]. Nat Commun, 2022, 13(1):2800. |
[19] | Li X, Chen X, Wen L, et al. Impact of TP53 mutations in breast cancer: clinicopathological features and prognosis impact of TP53 mutations in breast CA[J]. Thorac Cancer, 2020, 11(7):1861-1868. |
[20] | Muller PA, Vousden KH. p53 mutations in cancer[J]. Nat Cell Biol, 2013, 15(1):2-8. |
[21] | Yi Z, Ma F, Rong G, et al. Clinical spectrum and prognostic value of TP53 mutations in circulating tumor DNA from breast cancer patients in China[J]. Cancer Commun (Lond), 2020, 40(6):260-269. |
[1] | LI Hui, YIN Yu, LI Chunxiao, et al. Research progress on rehabilitation effect of respiratory training on breast cancer-related lymphedema [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2023, 19(4): 430-. |
[2] |
ZHAO Yifei, ZOU Yun, CHEN Hui, et al.
Analysis of mutation type and clinical significance of congenital melanocytic nevi [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2023, 19(3): 258-. |
[3] | ZHU Danli, BAO Wanting, WEI Hao, et al. Advances in breast reconstruction after breast cancer surgery [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2023, 19(2): 201-. |
[4] | ZHU Qiaoli, MIAO Yiming, CHEN Xiaosong. Prognostic analysis of breast-conserving surgery or mastectomy in patients with stage Ⅰ-Ⅲ triple-negative breast cancer [J]. Journal of Surgery Concepts & Practice, 2023, 28(04): 371-377. |
[5] | YANG Yi, YANG Xingxia, JIN Sili, ZHANG Xu, ZHU Juanying, CHEN Xiaosong. Clinical application of preoperative MRI examination in breast-conserving surgery for ductal carcinoma in situ [J]. Journal of Surgery Concepts & Practice, 2023, 28(04): 378-382. |
[6] | DONG Jun, CUI Fengming, LIU Jun. Effects of silencing Ki-67 gene on doxorubicin resistance of breast cancer MCF-7/DOX cells [J]. Journal of Surgery Concepts & Practice, 2023, 28(03): 254-259. |
[7] | SONG Luqian, CHANG Chunkang. Interpretation of clinical practice guidelines for myelodysplastic syndrome (version 1, 2023) of National Comprehensive Cancer Nerwork(NCCN) [J]. Journal of Diagnostics Concepts & Practice, 2023, 22(02): 116-120. |
[8] | QIAO Minjie, ZHOU Wei, CHEN Yi. Role of serum high mobility group box-B1 in evaluating prognosis of sepsis [J]. Journal of Internal Medicine Concepts & Practice, 2023, 18(02): 70-75. |
[9] | GAO Weiqi, ZHANG Xu, WANG Zheng, ZHU Yifei, HUANG Jiahui, HONG Jin, ZHU Siji, CHEN Xiaosong, HUANG Ou, HE Jianrong, CHEN Weiguo, LI Yafen, SHEN Kunwei, XU Hua, WU Jiayi. Safety analysis of immediate breast reconstruction with deep inferior epigastric perforator after neoadjuvant treatment [J]. Journal of Surgery Concepts & Practice, 2023, 28(02): 147-151. |
[10] | XU Jiankun, ZHOU Luting, ZHANG Wenjing, XU Haimin, WANG Chaofu. The prognostic value of CA9 expression in clear cell renal cell carcinoma [J]. Journal of Diagnostics Concepts & Practice, 2023, 22(01): 37-43. |
[11] | WANG Han, LU Haidi, WANG Lei, CONG Wenming, ZHENG Jianming, BAI Chenguang. Clinicopathological features of 2 cases of squamous cell carcinoma and 2 cases of adenosquamous carcinoma [J]. Journal of Diagnostics Concepts & Practice, 2023, 22(01): 44-49. |
[12] |
ZHANG Xiaoli, LI Zan, SONG Dajiang, et al.
Clinical application of the pedicled lateral thoracic artery perforation flap in breast reconstruction immediately after breast-conserving surgery [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2022, 18(5): 382-. |
[13] |
SONG Dajiang, LI Zan, ZHANG Yixin.
Surgical strategy of huge chest wall defect reconstruction using pedicled rectus abdominis musculocutaneous flap combined with free deep inferior epigastric artery perforator flap [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2022, 18(5): 386-. |
[14] |
CHEN Kuo, SONG Dajiang, MU Lan, et al.
Repair of abdominal wall donor site defect of TRAM by freeing the anterior rectus sheath of superior rectus abdominis -- An attempt to make patch with autologous tissue [J]. Journal of Tissue Engineering and Reconstructive Surgery, 2022, 18(5): 393-. |
[15] | LIU Min (刘 敏), YI Ming (易 鸣), WU Minghu∗ (武明虎), WANG Juan (王 娟), HE Yu (何 宇). Breast Pathological Image Classification Based on VGG16 Feature Concatenation [J]. J Shanghai Jiaotong Univ Sci, 2022, 27(4): 473-484. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||