三阴性乳腺癌患者的临床特点及预后分析  

Clinical characteristics and prognosis of triple negative breast cancer

作　　者：杜彩文[1] 陈宏武[2] 黄文河[2] 张国君[2] 洪超群[2] 陈炯玉[2] 魏晓龙[2] 马长春[2] 

机构地区：[1]汕头大学医学院附属肿瘤医院内科,广东汕头515031 [2]汕头大学医学院附属肿瘤医院乳腺中心,广东汕头515031

出　　处：《中国现代医药杂志》2010年第2期16-19,共4页Modern Medicine Journal of China

基　　金：广东省科学计划国际合作项目(2009B050200013)

摘　　要：目的分析三阴性乳腺癌患者的临床特点及其预后的相关因素。方法收集1998年1月1日～2008年12月31日汕头大学医学院附属肿瘤医院收治的712例原发性乳腺癌女性患者的临床资料,经免疫组化检查证实ER、PR和HER2/neu均为阴性的三阴性乳腺癌144例(20.2%)。回顾性分析三阴性乳腺癌患者的临床特点及其生存预后等情况。采用χ2检验进行单因素分析,Kaplan-Meier法计算生存率。结果本组病例中有20.2%(144/712)为三阴性乳腺癌,多见于有恶性肿瘤家族史者,而与患者年龄、肿瘤大小、淋巴结情况无明显关系。截至2009年10月31日,144例三阴性乳腺癌患者中位随访时间为26个月(2～147个月),有57例患者出现复发及转移,38例已死亡。三阴性乳腺癌组局部复发率及骨、脑转移发生率与非三阴性乳腺癌(non triple-negative breast cancer,Non-TNBC)组患者相比并未发现显著性差异,但三阴性乳腺癌患者肺、肝转移发生率明显高于非三阴性乳腺癌。生存分析显示,三阴性乳腺癌患者的2、5、10年无病生存率分别为71.1%%、58.2%和53.7%,总生存率分别为80.8%、66.5%和55.2%。结论三阴性乳腺癌约占所有原发性乳腺癌中1/5。这些患者以伴有恶性肿瘤家族史、容易发生内脏转移及总生存率低为主要特点,而与患者年龄、肿瘤大小、淋巴结情况无明显关系。伴有恶性肿瘤家族史、容易出现肺转移和肝转移可能与该器官表达某些特异性受体有关,也可能是导致三阴性乳腺癌预后较差的重要原因。Objective To analyze the clinical characteristics and prognostic factors of the patients with triplenegative breast cancer （TNBC）.Methods Retrospectively analyzed the clinical characteristics and survival of the 712 patients with primary breast cancer who were treated at Cancer Hospital of Shantou University Medical College from 1998-01-01 to 200812-31.144 of the 712 patients （20.2%） were confirmed to be TNBC by pathologist of the department of Shantou University Medical College.Results The percentage of TNBC in this study was 20.2%,they were commonly with familial history of malignancy,but not associated with young age,larger size and node status.By 2009-10-31,the median time of follow-up was 26 months （2～147 months）.Of the 144 patients,57 had local recurrence or metastasis,and 38 died.There was no significant difference in local recurrence and metastasis between TNBC and non-TNBC patients.But the occurrence rates of lung metastasis and liver metastasis were significantly higher in TNBC patients than that in non-TNBC patients.The 2-year,5-year and 10-year disease-free rates of TNBC were 71.1%,58.2% and 53.7% respectively,and the 2-year,3-year and 5-year overall survival rates were 80.8%,66.5%,and 55.2% respectively.Conclusion About one fifth of breast cancer patients are TNBC.These patients are commonly with family history of malignancy,with high bowel metastasis and low overall survival rate,but not associated with young age,larger size and node status.Lung metastasis and liver metastasis are common in TNBC which may due to some specific receptors of these organs,and these may be the main reasons of poor prognosis of TNBC.

关 键 词：三阴性乳腺癌 乳腺癌 临床特点 

分 类 号：R737.9[医药卫生—肿瘤] R743.34[医药卫生—临床医学]