三阴性乳腺癌的临床特征及预后分析  

Clinicopathologic features and prognosis of triple negative breast cancer

作　　者：周涛[1] 杨丽[2] 马国明[1] 李春晓[1] 白杨[1] 赵冀安[1] 王小玲[3] 耿翠芝[1] 

机构地区：[1]河北医科大学第四医院外一科、河北省乳腺疾病诊治中心,石家庄050011 [2]河北医科大学第四医院CT室,石家庄050011 [3]河北医科大学第四医院病理科,石家庄050011

出　　处：《中华医学杂志》2009年第32期2261-2264,共4页National Medical Journal of China

基　　金：基金项目：河北省高等院校强势特色学科资金（冀教高[2005]52号）

摘　　要：目的分析三阴性乳腺癌（TNBC）的临床特征及其预后。方法选取2004年1月至2004年12月河北医科大学第四医院外一科手术切除并经病理证实的女性原发性乳腺癌477例，进行免疫组化检测后分成两组，免疫组织化学（IHC）标记雌激素受体（ER）、孕激素受体（PR）、人类表皮生长因子2（HER2）均为阴性组为TNBC，另一组即为非三阴乳腺癌。比较两组乳腺癌的临床病理特征，Kaplan—Meier法分析两组无病生存（DFS）及总生存（OS）。结果本组TNBC60例，占12．6％（60／477），年龄〈50岁46例，占76．7％（46／60），肿瘤直径〉5cm17例，占28．3％（17／60），腋淋巴结阳性41例，占68．3％（41／60），组织学Ⅲ级19例，占31．7％（19／60），有乳腺癌家族史8例，占13．3％（8／60），以上指标与非三阴组相比，差异有统计学意义（P〈0．05）；截至2008年6月，所有病例中位随访时间48个月（42～54个月），TNBC组复发转移16例（16／60，26．7％），显著高于非三阴性组（64／417，15．3％）；TNBC组与非三阴组的42个月DFS分别为68．3％和79．6％，OS分别为81．7％和90．9％，差异有统计学意义（Log—Rank=3．917，P=0．048；Log—Rank=4．838，P=0．028）。结论三阴性乳腺癌多见于年龄〈50岁患者，肿瘤生长快，侵袭性强、预后差。Objective To analyze the clinicopathologic features and prognosis of triple negative breast cancer. Methods The clinical datas of 477 patients of primary breast cancer which were diagnosed by pathology in the 4th Hospital of Hebei Medical University from Jan. 2004 to Dec. 2004 were analyzed. All of the patients were divided into two groups according to the results of immunohistochemistry ： one was triple negative breast cancer （TNBC） which included estrogen receptor （ER） negative, progesterone receptor （PR） negative and human epidermal growth factor receptor （HER2） negative and other was non-triple negative breast cancer. We compared TNBC with the group of non-triple negative breast cancer in the clinicopathologic features . The disease-free survival （DFS） and overall survival （OS） were analyzed by Kaplan-Meier method. Results Of the 477 patients, 12. 6% （60/477）was TNBC patients in which 76. 7% of age was younger than fifty years（46/60） , 28. 3% of T 〉5 cm（ 17/60）, 68. 3% of lymph nodes metastasis （41/60） ,31.7% of grade Ⅲ（19/60） and 13. 3% of family history of breast cancer（8/60 ）, （P 〈0. 05 ）. Till June 2008, the median time of follow-up was 48 months （42 - 54 months ）. Local recurrenee or distant metastasis were 26. 7% （16/60） of TNBC which was higher than 15. 3% （64/417） of non-triple negative cases; DFS was 68. 3% in TNBC group and 79. 6% in the non-triple negative breast cancer group. The OS was 81.7% in TNBC group and 90. 9% in the non-triple negative breast eaneer group（ Log-Rank = 3. 917 ,P = 0. 048 ; Log-Rank = 4. 838,P = 0. 028 ）. Conclusion These patients of triple negative breast carcinoma were usually young （age 〈 50）, with tumor growth fast, much more invasion and poorly prognosis.

关 键 词：乳腺肿瘤 受体 雌激素 受体 孕激素受体 

分 类 号：R686[医药卫生—骨科学]