目的 评估使用炎症、免疫及营养指标对于胃癌根治术后发生腹膜转移的预测作用，并建立适用于术前风险评估的预测模型。方法 回顾性收集2022—2024年苏州市立医院85例晚期胃癌患者的临床资料，按术后是否发生腹膜转移分为转移组44例与非转移组41例。通过分析比较两组间的营养参数［血清白蛋白、纤维蛋白原及预后营养指数（PNI）］、炎症指标［中性粒细胞计数、C反应蛋白、中性粒细胞与淋巴细胞比值（NLR）及全身免疫炎症指数（SII）］、肿瘤标志物以及免疫功能指标（淋巴细胞计数、IL-2、IL-6、TNF-α和IFN-γ）等。使用单因素及多因素Logistic回归分析确定独立预测因子，并构建预测模型，采用Bootstrap法内部验证，计算校正后的曲线下面积及收缩因子，以优化模型性能。结果 多因素分析结果显示，IL-6（OR=1.116，95%CI：1.020~1.224）与CA125（OR=1.016，95%CI：1.006~1.026）为术后腹膜转移的独立预测因素，构建的预测模型区分能力良好，初始AUC为0.801（95%CI：0.702~0.900），经Bootstrap校正后AUC为0.797，模型校准度理想，具有良好的临床稳健性。结论 基于术前IL-6和CA125水平的预测模型，可用于评估胃癌患者根治术后发生腹膜转移的风险。该模型可在术前阶段有效识别高风险病例，为临床制定个体化辅助治疗方案及随访策略提供关键参考，并具有改善患者预后的潜在价值。

       Objective To evaluate the predictive value of inflammatory，immune，and nutritional indicators for peritoneal metastasis after radical gastrectomy in gastric cancer and to establish a predictive model applicable for preoperative risk assessment．Methods Clinical data from 85 patients with advanced gastric cancer treated at Suzhou Municipal Hospital between 2022 and 2024 were retrospectively collected．Patients were divided into two groups based on postoperative peritoneal metastasis occurrence：a metastasis group（n=44）and a non-metastasis group（n=41）．Indicators analyzed and compared between groups included nutritional parameters（serum albumin，fibrinogen，PNI），inflammatory markers（neutrophil count，CRP，NLR，SII），tumor markers and immune indicators（lymphocyte count，IL-2，IL-6，TNF-α，IFN-γ）．Univariate and multivariate logistic regression analyses identified independent predictors for constructing the prediction model．Internal validation was performed using 1 000 bootstrap resamples to calculate the adjusted area under the curve（AUC）and shrinkage factor for model optimization．Results Multivariate analysis identified IL-6（OR=1.116，95%CI：1.020-1.224）and CA125（OR=1.016，95%CI：1.006-1.026） as independent predictors of postoperative peritoneal metastasis．The constructed predictive model demonstrated good discriminatory ability，with an initial AUC of 0.801（95%CI：0.702–0.900）and a bootstrap-corrected AUC of 0.797．The model exhibited ideal calibration and good clinical robustness．Conclusions This study established a predictive model based on preoperative IL-6 and CA125 levels to assess the risk of peritoneal metastasis after radical surgery in gastric cancer patients．The model effectively identifies high-risk cases preoperatively，providing critical guidance for developing individualized adjuvant treatment and follow-up strategies，with potential to improve patient prognosis．

       乳腺癌（BC）发病率持续上升，已成为严重威胁公共健康的重大挑战，转移仍是导致患者死亡的主要原因。目前，切除肿瘤并辅以放化疗后仍有较大几率发生转移。此外，早期转移隐匿性强，干预措施不完善及耐药发生迅速均是预后不良的重要因素。细胞外囊泡（EVs）是由细胞释放的、具有膜结构的纳米级颗粒，是细胞间通讯的重要介质。EVs通过转运膜性组分、胞质蛋白及核酸等，调控乳腺癌的发生、进展及转移定植，其来源异质性决定了其在乳腺癌转移中发挥独特作用。本文重点总结了不同来源EVs作为液体活检标志物在转移预警中的价值，以及靶向EVs分泌或阻断其通讯网络在克服免疫治疗耐药中的潜在临床应用，以期为临床医生提供有价值的诊疗参考。

     The incidence of breast cancer（BC） continues to rise and has become a major public health challenge．Metastasis remains the principal cause of BC-related mortality．Currently，there remains a high probability of metastasis even after surgical tumor resection followed by radiotherapy and chemotherapy．The insidious nature of early metastasis，inadequate intervention strategies，and rapid development of drug resistance are all critical factors contributing to poor prognosis．Extracellular vesicles（EVs） are membrane-enclosed，nanoscale particles released by cells．As mediators of intercellular communication，EVs transfer membrane components，cytosolic proteins，and nucleic acids to recipient cells，thereby modulating BC initiation，progression，and metastatic dissemination．The heterogeneity of EV origins determines their distinct roles in breast cancer metastasis．This review focuses on summarizing the value of EVs from different sources as liquid biopsy biomarkers for metastasis warning，as well as their potential clinical applications in targeting EV secretion or blocking their communication networks to overcome immunotherapy resistance，aiming to provide valuable diagnostic and therapeutic references for clinicians．

目的 探讨动态对比增强磁共振成像（DCE-MRI）多参数定量特征对乳腺癌腋窝淋巴结转移（ALNM）风险的预测价值。方法 回顾性收集2020年3月—2022年11月在佛山市高明区人民医院经手术病理确诊的155例乳腺癌患者临床资料,根据患者是否发生ALNM分为ALNM 组（n=39）和无ALNM 组（n=116）。采用单因素分析和多因素Logistic回归分析乳腺癌发生ALNM的影响因素。结果 ALNM组和无ALNM 组患者的肿块质地、肿块直径、肿块部位、肿块形状、肿块内部强化特征等指标比较差异无统计学意义（t/χ²=2.249、0.977、1.369、0.524、2.158,P>0.05）。两组患者肿块表观扩散系数（ADC）值、腋窝淋巴结（ALN）短径、肿块边缘、动态增强时间-信号强度曲线（TIC）曲线等指标比较,差异有统计学意义（t/χ²=6.573、9.873、29.441、2.031,P<0.05）。二元Logistic回归模型结果显示,肿块ADC值、ALN 短径（≥5 mm）、TIC曲线（流出型）为乳腺癌ALNM发生的危险因素（OR=0.251、0.106、0.002,P<0.05）。结论 DCE-MRI多参数定量特征中,乳腺癌患者的肿块ADC值低、ALN 短径（≥5 mm）、TIC曲线（流出型）为乳腺癌ALNM发生的危险因素。

Objective To investigate the predictive value of multi-parameter quantitative features of dynamic contrast-enhanced magnetic resonance imaging（DCE-MRI）in the risk of axillary lymph node metastasis（ALNM）in breast cancer．Methods Clinical data of 155 patients with breast cancer diagnosed by surgery and pathology in Foshan Gaoming District People's hospital from March 2020 to November 2022 were retrospectively collected．According to whether the patients had ALNM,they were divided into ALNM group（n=39）and non-ALNM group（n=116）．Univariate analysis and multiple Logistic regression models were used to explore the influencing factors of ALNM in breast cancer．Results There was no significant difference in mass texture,mass diameter,mass location,mass shape and internal enhancement between the ALNM group and the non-ALNM group（t/χ²=2.249,0.977,1.369,0.524,2.158,P>0.05）．There were significant differences in ADC value,ALN short diameter,tumor margin and TIC curve between the two groups（t/χ²=6.573,9.873,29.441,2.031,P<0.05）．Binary Logistic regression model showed that ADC value,ALN short diameter（≥5 mm）and tumor margin（blur）were risk factors for the occurrence of breast cancer ALNM（OR=0.251,0.106,0.002,P<0.05）．Conclusions Among the multi-parameter quantitative features of DCE-MRI,the ADC value of breast cancer,the short diameter of ALN（≥5 mm）,and the edge of the tumor（blur）are the risk factors for the occurrence of ALNM in breast cancer．

目的 探讨容积调强（VMAT）在全脊柱骨多发转移瘤放疗中的运用,观察疗效及安全性。方法 选取 2018年1月—2021年1月本科室收治的50例全脊柱骨多发转移瘤姑息止痛放疗的临床资料,分别对全脊柱靶区设计适形放疗（CRT）和VMAT多中心计划,运用剂量体积直方图及所对应的统计表评估靶区及危及器官剂量覆盖情况,放疗结束后通过1-8周视觉模拟评分法评价近期疗效,每3个月复查全脊柱MRI观察放疗不良反应。结果 采用VMAT技术放疗靶区剂量覆盖度、靶区适形指数和剂量均匀指数均优于CRT技术（P<0.01）,照射野重叠区未见明显剂量热点和冷点。采用VMAT技术危及器官V5 Gy受照体积高于CRT（P<0.01）,除了胃、胰腺和小肠,危及器官V10 Gy受照体积高于CRT（P<0.01或P<0.05）,危及器官V20 Gy受照体积则低于CRT（P<0.01）,除了肾,危及器官V30 Gy受照体积也低于CRT（P<0.01）。采用VMAT技术时危及器官的最大受照量低于CRT（P<0.01或P<0.05）,但除了心脏、胰腺和小肠,VMAT技术的危及器官平均受照量高于CRT（P<0.01或P<0.05）。采用VMAT技术较CRT出束时间增加（P<0.01）,采用CRT时技师摆位时间较VMAT增加（P<0.05）,对于总治疗时间VMAT较CRT增加（P<0.01）。8周后评估疼痛完全缓解16例,部分缓解 22例,轻度缓解8例,无效4例,总有效率为76%。随访日期截至2021年 12月,所有配合随诊的患者3、6、9、12个月全脊柱MRI复查结果显示,VMAT技术照射野内重叠处均未见脊髓及其他组织急慢性损伤情况。结论 VMAT技术对长靶区多中心放疗剂量分布均匀,近期疗效显著,安全性良好。

Objective To investigate the application of volumetric modulated arc therapy（VMAT） in the radiotherapy for multiple bone metastases in the whole spine,and observe of efficacy and evaluation of safety．Methods The clinical data were selected from 50 patients who were treated in our department between January 2018 and January 2021 with palliative analgesic radiotherapy for multiple metastases of the whole spine．Conformal radiotherapy（CRT）and multicenter VMAT plans were respectively applied to target areas of whole spine,and dose volume histogram was used to evaluate the dose coverage of target area and organ at risk（OAR）. After radiotherapy,the short-term efficacy was evaluated by visual analog scale in between 1-8 weeks,and the whole spine MRI was reviewed every 3 months to observe the adverse reactions of radiotherapy．Results The dose coverage,target conformality index and homogeneity index of VMAT treatment were significantly better than those of CRT treatment（P<0.01）,and no obvious dose hotspots and cold spots were observed in the overlapping area of irradiation field. When VMAT treatment was applied,the exposure volume of V5 Gy in OAR was significantly higher when compared with CRT treatment（P<0.01）．Except for stomach,pancreas and small intestine,the exposure volume of V10 Gy in OAR was significantly higher for VMAT treatment when compared with CRT treatment （P<0.01 or P<0.05）．When VMAT treatment was applied,the exposure volume of V20 Gy in OAR was significantly lower when compared with CRT treatment（P<0.01）,and except for kidney,the exposure volume of V30 Gy in OAR was significantly lower when compared with CRT treatment（P<0.01）．When VMAT treatment was applied,the maximum exposure of OAR was significantly lower than that of CRT（P<0.01 or P<0.05）,however,except for the heart,pancreas and small intestine,the average exposure of VMAT treatment to OAR was higher than that of CRT （P<0.01 or P<0.05）．Compared with CRT,VMAT treatment had significantly increased beam-out time（P<0.01）,the therapist setting time of CRT was increased when compared with that of VMAT（P<0.05）,and the total treatment time of VMAT was increased when compared with that of CRT（P<0.01）. In the assessment 8 weeks after the treatments,16 patients had complete pain relief,22 had partial relief,8 had mild relief,and 4 had no effect,which total effective rate was 76%．The follow-up was ended in December 2021．There was no acute or chronic injury to the spinal cord and other tissues in the overlapping areas of the irradiation fields observed for all follow-up patients in the 3rd,6th,9th and 12th month whole-spine MRI re-examination．Conclusions VMAT has uniform dose distribution in multi-center radiotherapy for long target areas,with significant short-term efficacy and safety.

直肠癌是全球常见的消化道恶性肿瘤之一,准确的影像学评估对直肠癌的诊断和治疗决策至关重要。在各种影像学检查中,磁共振成像已逐渐成为直肠癌不可或缺的检查手段,其中酰胺质子转移加权（APTw）成像是当前直肠癌磁共振成像中的一种极具发展前景的成像技术,其是通过检测病灶中内源性可移动蛋白的酰胺质子与水质子之间的交换,可以更好地在分子水平评估直肠癌病灶的蛋白质浓度、pH值、温度和代谢状态等,在直肠癌中有极大的应用潜能,有助于实现精准医疗。本文主要综述APTw成像在直肠癌中的研究进展、发展前景及尚存在的问题。

Rectal cancer is one of the most common gastrointestinal malignancies worldwide, and accurate imaging evaluation is essential for the diagnosis and treatment of rectal cancer．In various imaging examinations, magnetic resonance imaging（MRI）has gradually become an indispensable means of rectal cancer, among which amide proton transfer-weighted（APTw）imaging is a promising imaging technology．APTw imaging is to detect the exchange between amide protons of endogenous mobile proteins in lesions and water quality particles, which can better assess the protein concentration, pH, temperature, and metabolic status of rectal cancer at the molecular level．It has great application potential in rectal cancer and contributes to precision medicine．This article mainly reviews the research progress, development prospect and remaining problems of APTw imaging in rectal cancer．

目的 探讨核结合蛋白2(NUCB2)介导的下游信号分子和通路,为阐明NUCB2在乳腺癌中的功能提供依据。方法 构建NUCB2-RNAi慢病毒载体,感染MDA-MB-231细胞株。然后将MDA-MB-231分为阴性对照病毒感染细胞组(NC组)、感染NUCB2基因shRNA病毒细胞组(KD组),用Affymetrix基因表达谱芯片对NUCB2下游基因进行筛选,并对所有数据进行独创性通路分析(IPA)分析。用qPCR测定mRNA水平。统计采用SPSS 20.0软件。结果 Path-Array研究筛选了KD组与NC组的差异基因,其中上调基因186个,下调基因356个,部分差异表达基因的检测表明,这些基因的mRNA水平与Path-Array筛选结果一致。IPA分析显示,经典途径中差异表达基因的显著富集表明胆固醇生物合成的超途径被显著抑制。上游调节因子分析显示了所有不同表达基因的上游调节因子,包括转录因子、细胞因子、小RNA、受体、激酶、化学分子和药物。疾病和功能差异表达基因的显著丰富表明,与NUCB2相关的差异表达基因与41种疾病和功能显著相关,更多与癌症、组织损伤和异常相关。结论 NUCB2的功能涉及多种基因和多种信号通路。

Objective In order to further explore the downstream signal molecules and pathways mediated by nucleobindin-2 (NUCB2), to provide a basis for elucidating the significance of NUCB2 in breast cancer. Method NUCB2-RNAi lentivirus vector was constructed and infecting MDA-MB-231 cell line.Then MDA-MB-231 cells were divived into two group, cells with negative control virus infection (NC group) and cells infected with NUCB2 gene shRNA virus (KD group). NUCB2 downstream gene screening was conducted by Affymetrix gene expression profiling Path-Array chip and all data were analyzed by ingenuity pathway analysis (IPA). The mRNA level was detected by qPCR. SPSS 20.0 software was used for statistics. Results Path-Array study screened out differential genes between KD and NC group which the number of up-regulated genes was 186, the number of down-regulated genes was 356.Detection of some differentially expressed genes showed that the mRNA levels of these genes were consistent with the results of Path-Array screening.IPA analysis revealed that significant enrichment of differentially expressed genes in the classical pathway showed superpathway of cholesterol biosynthesis was significantly inhibited.The upstream regulatory factor analysis showed the upstream regulatory factors of all the differentially expressed genes, including transcription factors, cytokine, small RNA, receptors, kinases, chemical molecules and drugs.The significant enrichment of differentially expressed genes in disease and function showed that NUCB2 associated differentially expressed genes were significantly related with 41 diseases and functions, which were more related with cancer, organismal injury and abnormities. Conclusion The function of NUCB2 involved multiple genes and multiple signaling pathways.

目的 本文主要探讨信迪利单抗联合化疗治疗复发转移食管癌的临床有效性和安全性。方法 选取2018年1月—2020年1月我院收治的复发转移食管癌患者共98例纳入研究。按照随机数字表法将患者分为对照组(49例)和观察组(49例),对照组给予多西他赛75 mg/m²+顺铂75 mg/m²治疗,观察组在对照组的基础上给予信迪利单抗(200 mg)治疗,分析比较2组临床疗效及不良反应,主要评估指标是随访期间患者中位生存时间。结果 观察组临床治疗有效率高于对照组(P<0.05);与治疗前比较,2组治疗后血清糖类抗原-199(CA-199)、癌胚抗原(CEA)及肿瘤特异生长因子(TSGF)水平均降低(P<0.05);与对照组比较,观察组治疗后血清CA-199 、CEA及TSGF水平降低(P<0.05);2组临床不良反应主要以恶心呕吐、皮疹等为主,观察组免疫相关不良事件发生率高于对照组(P<0.05),但总不良反应发生率比较无差异(P>0.05);随访至2020年10月,观察组中位OS为16个月(5～27个月),对照组中位总生存期(OS)为9个月(3～23个月),观察组中位OS长于对照组(P<0.001)。结论 信迪利单抗联合化疗可提高复发转移食管癌的临床治疗效果,降低肿瘤抗原水平,延长患者生存时间,且临床较为安全。

目的 分析术前血清鳞状细胞癌相关抗原(SCCA)对宫颈鳞癌患者发生盆腔淋巴结转移的预测价值。方法 选取2018年1月—2021年1月于我院肿瘤科治疗的128例宫颈鳞癌患者作为研究对象,根据其是否发生盆腔淋巴结转移将其分为转移组(42例)和非转移组(86例)。对比2组宫颈鳞癌患者一般资料,采用多因素Logistic分析宫颈鳞癌患者发生盆腔淋巴结转移的高危因素,采用ROC曲线评估术前血清SCCA对宫颈鳞癌患者发生盆腔淋巴结转移的预测价值,通过约登指数确定最佳截断值。结果 2组患者一般资料对比,宫颈鳞癌细胞分化程度、宫颈鳞癌临床分期、宫颈鳞癌肿瘤直径大小、是否出现宫旁转移现象、是否出现脉管浸润现象、浸润深度、SCCA水平的差异有统计学意义,P<0.05;多因素Logistic分析显示宫颈鳞癌细胞分化程度、脉管浸润阳性、浸润深度、SCCA水平是宫颈鳞癌患者发生盆腔淋巴结转移的危险因素;ROC曲线分析结果显示,SCCA水平曲线下面积为0.909,最佳截断值为0.597 5 μg/L。结论 术前血清SCCA水平对宫颈鳞癌患者发生盆腔淋巴结转移具有预测价值。

Objective To analyze the predictive value of preoperative serum squamous cell carcinoma antigen (SCCA) on pelvic lymph node metastasis in patients with cervical squamous cell carcinoma.Methods A total of 128 patients with cervical squamous cell carcinoma treated in the oncology department of our hospital from January 2018 to January 2021 were selected as the research objects,and divided into metastatic group (42 cases) and non-metastatic group (86 cases) according to whether pelvic lymph node metastasis occurred.The general data of the two groups of patients with cervical squamous cell carcinoma were compared.Multivariate logistic analysis was used to analyze the risk factors for pelvic lymph node metastasis in patients with cervical squamous cell carcinoma.ROC curve was used to evaluate the predictive value of preoperative serum SCCA for pelvic lymph node metastasis in patients with cervical squamous cell carcinoma,and the optimal cut-off value was determined by Yoden index.Results When comparing the general data of the two groups of patients,the differences in the degree of cervical squamous carcinoma cell differentiation,clinical stage of cervical squamous carcinoma,tumor diameter of cervical squamous carcinoma,whether the phenomenon of parametastasis was present,whether the phenomenon of choroidal infiltration was present,depth of infiltration,and SCCA level were statistically significant,P<0.05; multi-factor logistic analysis showed that the degree of cervical squamous carcinoma cell differentiation,positive vascular invasion,depth of invasion and SCCA level were risk factors for pelvic lymph node metastasis in cervical squamous cell carcinoma patients.The results of ROC curve analysis showed that the area under the curve of SCCA level was 0.909 and the optimal cut-off value was 0.597 5 μg/L.Conclusions Preoperative serum SCCA level had good predictive value for the occurrence of pelvic lymph node metastasis in patients with cervical squamous carcinoma.

目的 探讨¹³¹I联合甘氨双唑钠治疗分化型甲状腺癌(differentiated thyroid carcinoma,DTC)骨转移的临床疗效。方法 以我院96例DTC骨转移患者为研究对象,随机分为对照组和观察组各48例,对照组仅予¹³¹I治疗,观察组予¹³¹I联合甘氨双唑钠治疗,比较两组的临床疗效、转移灶清除效果及不良反应。结果 根据骨痛评价标准,观察组的有效率(71.00%)高于对照组(48.00%)(P＜0.05)。根据血清甲状腺球蛋白(thyroglobulin,Tg)评价标准,观察组的有效率(77.00%)高于对照组(58.00%)(P＜0.05)。根据病灶影像学评价标准,观察组的有效率(48.00%)高于对照组(27.00%)(P＜0.05)。两组不良反应发生率差异无统计学意义(P＞0.05)。结论 ¹³¹I联合甘氨双唑钠可提高DTC骨转移患者临床疗效,具有临床推广意义。

Objective To explore the clinical effect of ¹³¹I combined with sodium glycididazole in the treatment of differentiated thyroid cancer (DTC) with bone metastasis. Methods Ninty-six patients with DTC bone metastasis were randomly divided into the control group and the observation group, forty-eight patients in each group. The control group was treated with ¹³¹I only, while the observation group was treated with ¹³¹I combined with glycididazole sodium. The clinical effect, metastasis clearance effect and adverse reactions of the two groups were compared. Results The effective rate of the observation group (71.00%) was higher than that of the control group (48.00%) (P<0.05) according to the evaluation criteria of bone pain. The effective rate of the observation group (77.00%) was higher than that of the control group (58.00%) (P<0.05) according to the evaluation criteria of serum thyroglobulin (Tg). The effective rate of the observation group (48.00%) was higher than that of the control group (27.00%) (P<0.05) according to the imaging evaluation criteria. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of ¹³¹I and sodium glycidazole can improve the clinical effect of patients with DTC bone metastasis, which has clinical significance for promotion.

目的 探讨分析30岁及以下青年乳腺癌患者术后首次复发转移特点,以期指导术后随访,早期发现转移病灶。方法 回顾性分析2003年1月—2018年8月在梅州市人民医院收治的年龄≤30岁乳腺癌患者73例,所有患者均行根治性手术治疗,分析临床病理特点及术后首次复发转移特点。结果 共纳入23例三阴性(31.5%)、20例luminal B(HER2-)型(27.4%)、12例HER-2阳性型(16.4%)、10例 Luminal B(HER2+)型(13.7%)、4例Luminal A型(5.5%)和4例分型不明(5.5%)。中位随访28.4个月,7例三阴性(7/23, 30.4%)、 6例HER-2阳性型(6/12, 50.0%)、 4例Luminal B(HER2-)型(4/20, 20.0%) 和3例 Luminal B(HER2+)型(3/10, 30.0%)出现复发转移。复发转移患者中,90.0%合并远处转移,75.0%合并内脏转移,其中HER-2阳性型均合并内脏转移;92.3%(12/13)激素受体阴性患者复发转移发生在术后2年内。三阴性患者最常见远处转移部位是远处淋巴结,HER-2阳性型患者最常见远处转移部位是肝,luminal B(HER2+)型患者最常见远处转移部位是肺和骨,luminal B(HER2-)型患者最常见远处转移部位是肺和远处淋巴结。结论 ≤30岁青年乳腺癌患者术后首次复发转移多合并远处转移,激素受体阴性患者容易早期复发,不同分子分型患者具有不同的好发远处转移部位。

Objective We retrospectively investigated the first recurrent pattern after radical surgery in breast cancer patients aged ≤30 years, so as to guide postoperative follow-up and early detection of recurrent lesions. Methods A total of 73 consecutive early breast cancer patients aged ≤30years admitted to Meizhou People's Hospital from January 2003 to August 2018 were included. Retrospective analysis was conducted to analyze the clinicpathologic characteristics and characteristics of first recurrent pattern. Results 23 triple negative(31.5%), 20 Luminal B(27.4%), 12 HER2 enriched (16.4%), 10 Luminal/HER2+(13.7%), 4 Luminal A(5.5%) and 4 undifined subtypes(5.5%) were included. After a median follow-up of 28.4 months, 20 patients relapsed, which included 7 triple-negative(7/23, 30.4%), 6 HER2-enriched (6/12, 50.0%), 4 luminal B(4/20, 20.0%) and 3 luminal/HER2+(3/10, 30.0%) subtypes. 90.0% of patients combined with distant metastasis. 75.0% of patients had visceral metastasis, which included all the recurrent HER-2 enriched patients. 92.3% of hormone receptor negative(HR-) patients had a RFS less than 2 years. The most common metastatic sites in triple-negative, HER-2-enriched, luminal/HER2+ and luminal B subtypes were distant nodes, liver, lung and bone, distant nodes and lung, respectively. Conclusion The first recurrent pattern mainly presented as distant metastasis in breast cancer patients aged≤30 years, with early relapse in patients with HR- diseases. Different molecular subtypes of breast cancer favor different distant metastatic sites.