目的

分析三阴性乳腺癌临床病理学特征及预后。

方法

收集2004年1月至2005年1月本院收治的1264例可手术乳腺癌患者的临床病理资料,并回顾性分析其中246例三阴性乳腺癌患者的临床病理学特征、复发转移及生存情况。采用SPSS 13.0软件进行统计学处理,频数资料组间比较采用χ²检验或Mann-Whitney U检验,生存分析采用Kaplan-Meier法,组间曲线比较用Log-Rank检验。

结果

三阴性乳腺癌患者占总患者数的19.46%(246/1264)。与非三阴性乳腺癌患者比较,三阴性乳腺癌患者小于35岁的患者所占比例大［8.54%(21/246),Z=-3.58,P=0.000］,有乳腺癌家族史者多［8.13%(20/246),χ²=5.98,P=0.014］,肿瘤直径≥5 cm者多［11.79%(29/246),Z=-2.70,P=0.007］,腋窝淋巴结阳性者多［58.13%(143/246),χ²=6.16,P=0.013］,组织学分级较高,Ⅲ级占20.73%(51/246,χ²=13.55,P=0.000)。其复发、转移发生率高,占20.33%(50/246,χ²=8.70,P=0.003)。三阴性乳腺癌患者的5年无瘤生存率和总生存率分别为79.67%(196/246)、89.84%(221/246),均明显低于非三阴性乳腺癌患者(χ²=8.70,P=0.003;χ²=15.07,P=0.000),其中骨、肺、脑、锁骨上淋巴结转移发生率明显高于非三阴性乳腺癌患者(P＜0.050)。亚组分析中,三阴组5年无瘤生存率明显低于HR(+)HER-2(-)组(χ²=7.55,P=0.006),且5年总生存率明显低于HR(+)HER-2(-)及HR(-)HER-2(+)组(χ²=15.31,P=0.000;χ²=5.77,P=0.016)。

结论

三阴性乳腺癌可以作为一种独特的乳腺癌亚型,复发、转移发生率高,临床预后差。

Objective

To analyze the clinicopathologic features and prognosis of patients with triple negative breast cancer.

Methods

The clinicopathologic data of 1264 cases of operable breast cancer treated in our hospital from January 2004 to January 2005 were collected.Among them there were 246 patients with triple negative breast cancer.Their clinicopathologic characteristics,recurrence and survival were summarized and retrospectively analyzed.SPSS13.0 software was used for statistic treatment.Chi-square test or Mann-Whitney U test was used for the comparison of frequency data between groups;Kaplan-Meier method was applied to analyze survivals,and Log-Rank was used to compare curves between groups.

Results

The triple negative breast cancer patients accounted for 19.46%of the total breast cancer patients(246/1264).Triple negative breast cancer occurred mostly in young patients,aged＜35 years,holding 8.54%(221/246,Z=-3.58,P=0.000);patients with family history accounted for 8.13%(20/246,χ²=5.98,P=0.014).The tumor diameter≥5 cm was in 29 patients,holding 11.79%(29/246,Z=-2.70,P=0.007);axillary lymph node metastasis was in 143 patients,holding 58.13%(143/246,χ²=6.16,P=0.013),and histological gradeⅢwas in 51 patients,occupying 20.73%(51/246,χ²=13.55,P=0.000).The 5-year disease-free and overall survival rates in the triple negative breast cancer patients were 79.67%(196/246)and 89.84%(221/246)respectively,significantly lower than those in the non-triple negative breast cancer patients(χ²=8.70,P=0.003;χ²=15.07,P=0.000),and the incidences of local recurrence and distant metastasis in the triple negative group was significantly higher than that in the non-triple negative group(P＜0.050).The analysis in the subgroups showed that the 5-year disease-free survival rates were significantly lower in triple negative breast cancer patients than in HR(+)HER-2(-)patients(χ²=7.55,P=0.006);the 5-year overall survival rates were significantly lower in the triple negative breast cancer patients than in HR(+)HER-2(-)and HR(-)HER-2(+)patients(χ²=15.31,P=0.000,andχ²=5.77,P=0.016).

Conclusion

Triple negative breast cancer can be taken as a special subtype of breast cancer.The incidences of recurrence and metastasis are high,and the prognosis is poor.