125例三阴性复发转移乳腺癌首发转移模式的分析  

The primary relapse pattern in 125 patients with triple negative advanced breast cancer

作　　者：李惠平[1] 刘笑然[1] 孔维垚 冉然[1] 张如艳[1] 张嘉杨 刘雅昕[1] 韩祎帆 刘慧敏[1] 金秋杰 LI Hui-ping LIU Xiao-ran KONG Wei-yao RAN Ran ZHANG Ru-yan ZHANG Jia-yang LIU Ya-xin HAN Yi-fan LIU Hui-min JIN Qiu-jie(Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education）, Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所乳腺肿瘤内科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《癌症进展》2016年第12期1184-1186,共3页Oncology Progress

基　　金：国家自然科学基金(81502269)

摘　　要：目的分析三阴性乳腺癌（TNBC）首次复发转移部位的特征,以指导复发转移性TNBC患者的治疗选择及管理。方法回顾性分析125例复发转移性TNBC患者的临床资料,对术后常见的复发转移部位和复发转移时间进行描述和统计,归纳其首次复发转移的模式。结果 125例复发转移性TNBC患者中,首次单发转移部位以淋巴结和肺最为常见,分别占11.2%和5.6%;首发即为多发转移的比例高达79.2%,其中,含淋巴结、肺、骨、肝和脑转移的比例分别为52.8%、34.4%、27.1%、14.4%和6.4%,其他特殊部位（包含肾上腺等）转移32例（25.6%）。首发内脏转移（仅包含肝和肺）63例,占50.4%,其中6例同时有肝和肺转移;淋巴结转移比例最高,为64.0%;合并肺转移（40.0%）的患者明显多于肝转移（15.2%）的患者（P=0.000）。复发转移的时间多在术后2~3年,2年内复发者52例（41.6%）,2~3年复发者23例（18.4%）,3年以上复发者50例（40.0%）。结论 TNBC淋巴结、肺转移多见;脑转移作为首发部位也值得关注;TNBC多发转移比例高;多数在2~3年内复发。建议在辅助治疗后的随访中,除了关注淋巴结的检查外,还需关注肺部和颅脑的检查,以早期发现复发征象。Objective To analyze the pattern of primary relapse and metastasis of triple-negative breast cancer（TNBC）, and to find out the optimal management for this group of patients. Method The clinical data of 125 patients with metastatic TNBC were retrospectively analyzed, the common relapse and metastasis sites and time were descriptively analyzed, and the patterns of primary relapse and metastasis were summarized. Result Of the 125 cases, primary solitary metastasis was common in lymph node and lung, which were observed in 11.2% and 5.6% of patients, respectively; while79.2% of patients had primary multiple metastases, involving lymph node, lung, bone, liver and brain（52.8%, 34.4%,27.1%, 14.4% and 6.4%, respectively）, other rare sites of metastasis（include adrenal gland, etc.） were observed in 32 cases（25.6%）. 63 cases（50.4%） of patients had primary visceral metastasis（only liver and/or lung）, in which 6 patients had both liver and lung metastases; lymph node involvement（64.0%） was the most; and patients with combined lung metastasis（40.0%） were obviously more than those with combined liver metastasis（15.2%）（P=0.000）. The time of relapse and metastasis was basically in 2 or 3 years after surgery, and 52 cases（41.6%） had relapse in 2 years, while 23 cases（18.4%）in 2- 3 years, and 50（40.0%） in 3 years. Conclusion TNBC comes with common metastasis in lymph node and lung;while primary brain metastasis is noteworthy; TNBC has high rate of multiple metastases; and most of the recurrence will occur in 2-3 years. Therefore, patients in follow-up after adjuvant treatment should not only be monitored for lymph node status, but also be checked for lung and brain, facilitating early diagnosis of relapse.

关 键 词：转移部位分布 进展期乳腺癌 三阴性 

分 类 号：R737.9[医药卫生—肿瘤]