雌激素受体阳性/孕激素受体阴性亚型是一种 特殊类型的乳腺癌
Estrogen Receptor-Positive/Progesterone Receptor-Negative/HER-2-Negative Breast Cancer Constitutes a Distinct Subtype of Breast Cancer
DOI: 10.12677/acm.2026.1631169, PDF,   
作者: 殷 丽：重庆市九龙坡区妇幼保健院乳腺外科，重庆；陆正嘉*：重庆医科大学附属第二医院乳腺甲状腺外科，重庆
关键词: 乳腺癌；雌激素受体；孕激素受体；分子分型；化疗；Breast Cancer； Estrogen Receptor； Progesterone Receptor； Molecular Typing； Chemotherapy
摘要: 乳腺癌是女性患者的常见恶性肿瘤，它是由于乳腺组织细胞在各种致癌因素的影响下癌变而产生的一种严重的病理现象。不同亚型的乳腺癌其临床病理特征、预后、治疗策略和病情转归都各不相同。激素受体阳性乳腺癌由于内分泌治疗的益处，通常与侵袭性较低和较好的预后相关。然而，孕激素受体的丢失会使患者出现内分泌抵抗，导致预后较差。雌激素受体阳性/孕激素受体阴性乳腺癌(ER+/PR−)是一种特殊类型的激素受体阳性乳腺癌，它的PR阴性表达，表现出更大的基因组不稳定性和更高的肿瘤细胞增殖率，许多患者在常规内分泌治疗初始阶段即发生原发性耐药。然而，目前对ER+/PR−型乳腺癌的研究较少，没有详细的研究解释导致此亚型出现独特表现的潜在机制，也没有相关指南和临床共识针对其做出个性化的治疗方案。本文提出了一种假说：ER+/PR−乳腺癌是乳腺癌的一种独立的亚型，他具有独特的临床特征及预后，介于ER+/PR+亚型与三阴性之间，更接近于三阴性乳腺癌(TNBC)。应当采取化疗作为手术后的强化辅助治疗方案，而不是内分泌治疗。此外，多西他赛、紫杉醇、长春瑞滨等化疗药物可能对ER+/PR−患者有更好的疗效。
Abstract: Breast cancer is a common malignant tumor in female patients, which is a serious pathological phenomenon caused by the canceration of breast tissue cells under the influence of various carcinogenic factors. Different subtypes of breast cancer have different clinicopathological features, prognosis, treatment strategies and prognosis. Hormone receptor positive breast cancer is usually associated with low invasiveness and good prognosis due to the benefits of endocrine therapy. However, the loss of progesterone receptor will cause endocrine resistance in patients and lead to poor prognosis. Estrogen receptor positive/progesterone receptor negative breast cancer (ER+/PR−) is a special type of hormone receptor positive breast cancer. Its PR negative expression shows greater genomic instability and higher tumor cell proliferation rate. Many patients develop primary drug resistance at the initial stage of routine endocrine therapy. However, at present, there is little research on ER+/PR− type breast cancer, and there is no detailed research to explain the potential mechanism leading to the unique performance of this subtype, and there is no relevant guideline and clinical consensus to make personalized treatment plan for it. This paper puts forward a hypothesis: ER+/PR− breast cancer is an independent subtype of breast cancer, which has unique clinical features and prognosis, ranging from ER+/PR+ subtype to triple negative breast cancer (TNBC). Chemotherapy should be used as an intensive adjuvant therapy after operation, rather than endocrine therapy. In addition, docetaxel, paclitaxel, vinorelbine and other chemotherapy drugs may have a better effect on ER+/PR− patients.
文章引用：殷丽, 陆正嘉. 雌激素受体阳性/孕激素受体阴性亚型是一种 特殊类型的乳腺癌[J]. 临床医学进展, 2026, 16(3): 3614-3624. https://doi.org/10.12677/acm.2026.1631169

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