三阴乳腺癌的临床病理特征及预后  

Analysis of clinicopathologic features and prognosis-related factors in triple-negative breast cancer

作　　者：林坚[1] 胡梅齐 彭炜[1] 马荣强[1] 

机构地区：[1]上海市中西医结合医院外科,上海200082

出　　处：《中国癌症杂志》2010年第6期462-465,共4页China Oncology

摘　　要：背景与目的:三阴乳腺癌(triple-negative breast cancer,TNBC)具有高侵袭性、恶性程度高、治疗棘手等特点。如何提高此类患者的治疗效果,有待于进一步的医学临床和基础研究。本研究旨在探讨TNBC的临床病理特征及预后。方法:回顾性分析2000年1月-2006年12月我院确诊为乳腺癌的407例患者,根据雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和人表皮生长因子受体2(human epidermal growth factor receptor2,Her-2)的表达情况,将其分为3组:三阴组(ER阴性、PR阴性、Her-2阴性)、非三阴组(除三阴组的其他乳腺癌)、Her-2阳性组(Her-2阳性),比较3组间就诊时淋巴结转移数率、术后复发转移率等病理特征以及术后肿瘤复发和生存情况。结果:全部乳腺癌患者中TNBC的比例为13.7%(56/407),三阴组患者就诊时处绝经前比例较高(P=0.01)。3组间淋巴结转移率差异无统计学意义(P>0.05)。三阴组T1期淋巴结转移率达50.0%,远高于T1期非三阴组11.1%及Her-2阳性组8.7%(P<0.05)。三阴组术后3年肿瘤复发率明显高于非三阴组及Her-2阳性组,分别为:57.1%(32/56)、40.5%(142/351)和44.2%(32/95),差异有统计学意义(P=0.03)。三阴组3年生存率明显低于非三阴组及Her-2阳性组,分别为58.9%(33/56)、76.4%(268/351)和74.8%(71/95),差异有统计学意义(P=0.04)。结论:TNBC患者诊断时非绝经期比例高、直径小的肿瘤亦有高淋巴结转移率、术后3年内复发率高、生存率低。Background and purpose： Triple-negative breast cancer has characteristics of highly invasiveness, high grade malignancy and is tough to treat. Further clinical and basic research should be done to improve treatment results. Our study was aimed to investigate the clinicopathologic features and prognosis in triple negative breast cancer patients. Methods： Four hundred and seven breast cancer patients have been operated between Jan. 2000 and Dec. 2006, and divided into 3 groups： triple negative group, non-triple negative （luminal a and b） group and Her-2 positive group. Clinicopathologic characteristics, recurrence rate and survival status of the three patients were analyzed among the three groups with a median follow-up of 3 years. Results： Of the 407 patients, 13.7% （56/407） were TNBC. In premenopausal group, TNBC patients was higher than the other groups （P=0.01）. The lymph node metastasis rate was similar among the 3 groups （P〉0.05）. However, 50.0% of T1 patients with TNBCs had lymph node metastasis, which was much higher than the other 2 groups. The recurrence rate in TNBC, non-TNBC or Her-2 positive patients were 57.1%, 40.5% and 44.2%, respectively. The triple negative group had higher tumor recurrence rate than the other two groups （P=0.03）. The overall 3 year survival rate of the TNBC group was 58.9%, which was much lower than the other two groups （76.4% for the luminal a and b group and 74,8% for the Her-2 positive group （P=0.04）. Conclusion： The TNBCs was higher in premenopausal patients well as a higher lymph nodes metastasis rate with small tumor size. Moreover, three years recurrence and mortality rates in this group is higher than the non-TNBC groups.

关 键 词：三阴乳腺癌 回顾性研究 预后 

分 类 号：R737.9[医药卫生—肿瘤]