三阴性乳腺癌的临床特征和预后分析  

Clinical Characteristics and Prognosis of Triple Negative Breast Cancer

作　　者：柴文英[1] 马芸[1] 钱锦贤[1] 蒋爱梅[1] 程若川[1] 

机构地区：[1]昆明医学院第一附属医院乳腺外科,昆明650032

出　　处：《肿瘤预防与治疗》2010年第1期36-40,88,共6页Journal of Cancer Control And Treatment

摘　　要：目的:分析三阴性乳腺癌的临床特征、生存情况和预后。方法:收集2002年2月至2004年2月昆明医学院第一附属医院收治的具有完整临床病理和随访资料的手术乳腺癌304例,根据免疫组化ER、PR和HER-2的检测结果分为三阴组和非三阴组,对比分析三阴性乳腺癌患者的临床特征、复发及生存情况。结果:本研究中三阴性乳腺癌患者81例(26.6%),多见于围绝经期妇女,中位年龄50.8岁(26岁～85岁);有乳腺癌家族史者8例(9.9%),浸润性导管癌58例(71.6%),组织学分级Ⅲ级者占49.0%,淋巴结转移率为44.4%;Ⅰ、Ⅱ、Ⅲ期患者分别占6.2%,70.4%和23.5%。随访至2009年2月,中位随访71个月(60个月～84个月)。三阴性乳腺癌患者的局部复发率、内脏转移率显著增高,5年的无病生存率和总生存率分别为76.5%和87.6%,显著低于非三阴性乳腺癌患者(84.7%和93.7%,P<0.05)。结论:三阴性乳腺癌,其发病有较高的家族倾向。三阴性乳腺癌组织学分级高,预后差,易发生局部复发和远处转移,转移具有明显的器官倾向性,以肺、肝、脑转移多见。三阴性乳腺癌是一个独立的预后指标。Objective： To analyze the clinicopathologic characteristics and prognosis of triple-negative breast cancer. Methods： Clinical data of 304 patients with histopathologically confirmed breast cancer in our hospital from Feb. 2002 to Feb. 2004 were analyzed. All the excised tissue was detected ER, PR and HER-2 status by immunohistochemistry. The patients were divided into the triple-negative breast cancer group（ER negative, PR negative and HER-2 negative） and the non-triple-negative breast cancer group. The clinical characteristics, recurrence rate and survival rate of the triple-negative breast cancer patients were analyzed. Results： In this study, 81 cases（26.6% ） were triple-negative breast cancer. Triple-negative breast cancer was commonly seen in perimenopausal women, and the median age of the patients was 50.8 years old（26 -85years old）, 8 cases（ 9.9% ） had familial history of breast cancer. Among the 81 cases, 58 cases （71.6%） were invasive ductal carcinomas ,49% were histological grade lII and 44.4% with lymph node metastasis. The percentage of triple-negative patients with clinical stage of Ⅰ、Ⅱ、Ⅲ was 6.2%, 70.4% and 23.5%, respectively. By Feb. 2009, the median time of follow-up was 71 months （60 -84 months）. There was significant difference in local recurrence rate and metastasis rate between triple-negative and non-triple-negative breast cancer patients. The 5-year disease-free rates （DFS） and overall survival rates （OS） were significantly lower in triple-negative breast cancer patients than in non-triple-negative breast cancer patients （76.5% vs. 84.7%; 87.6% vs. 93.7%; P 〈0.05）. Conclusion： There is inclining familial incidence in triple-negative breast cancer and with high histological grade . Compared with non-triple-negative breast cancer, triple-negative breast cancer has an increased possibility of local recurrence and distant mctastasis, leading to a poor prognosis. Triple-negative breast cancer is an independent prognostic factor that affects

关 键 词：三阴性乳腺癌 临床特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]