目的：探讨乳腺癌局部复发肿瘤组织受体表达变化对乳腺癌患者预后的影响。方法：收集2005年1月至2008年12月本院肿瘤科收治的乳腺原发癌经治疗后再次复发的患者56例，采用免疫组化SP法检测患者原发肿瘤组织和复发组织中的雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（Her-2）中的表达变化，并分析受体表达变化对患者总生存期（OS）的影响。结果：（1）原发灶和复发肿瘤灶中ER阳性率分别为60.71%(34/56)和55.36%(31/56)，PR阳性率分别为57.14%（32/56）和51.79%（29/56），Her-2阳性率分别为44.64%（25/56）和42.86%（24/56）；（2）ER在原发灶与复发灶的变化率为3393%（19/56），PR变化率为37.50%（21/56），Her-2 变化率为 8.93 %（5/56）；（3）56例乳腺癌患者死亡22例（39.29%），中位生存时间为21.5个月，1~5年的生存率分别为87.23%、75.65%、70.11%、60.22%、42.86%；Kaplian-Meier分析显示，原发灶和复发灶中ER及PR表达的变化均对患者OS有明显影响，ER由（-→+）较（+→-）预后为好（P=00478），PR由（-→+）较（+→-）预后为好（ P =0.0182），而Her-2的表达变化由于样本量太小无法评估其影响；（4）多因素分析表明，患者年龄、病理分型、肿瘤分期、是否转移及ER、PR均是影响乳腺癌患者OS的独立预测性因子。结论：乳腺癌患者原发灶与复发灶中ER、PR的表达变化对患者生存存在影响，检测患者肿瘤复发灶中这些受体表达情况，对患者的治疗及预后评估具有一定意义。

Objective: To assess the influence of the receptor expression changes in locally recurred tumors on the prognosis of breast cancer patients. Methods: The primary and recurrent tumor sections from 56 patients admitted to our department from January 2008 to December 2013 for both primary and recurrent breast cancers were investigated. The expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2(Her-2) was examined by immunohistochemistry. The association between changes of the receptors expression and overall survival (OS) of patients was then analyzed. Results:（1）The positive rates of the ER, PR, and Her-2 in the primary tumor and recurrent tumor sections were 64.29% and 55.36%, 53.57% and 39.29%, and 37.50% and 35.71 respectively. (2) The rates of altered expression between the primary and recurrent tumors for ER, PR, and Her-2 are 33.93% (16/56) 37.50% (21/56), and 8.93% (5/56). (3) Among 56 breast cancer patients, there were 22 death (39.29%) during the investigation period, the median survival time was 21.5 months, and the survival rates for 1 -5 years were 87.23%, 75.65%, 70.11%, 60.22%, 42.86%. Kaplian-Meier analysis revealed that alterations of ER and PR expression in primary and recurrent tumors affect OS of the patients. Patients whose ER and PR expression in primary and recurrent tumors changed from negative to positive have better prognosis than those who had ER and PR expression changed from positive to negative (P<0.05). There were not enough positive sections in this cohort to evaluate the effects Her-2 alterations. (4) Multivariable analysis indicated that age, tumor pathological type, stage, and metastasis, ER and PR expression are all independent prognostic factors for the OS of breast cancer.patients. Conclusion: The alteration of ER and PR expression in primary and recurrent tumors of breast cancer patients affects their OS. Assessing these changes will benefit the treatment and prognosis evaluation.