三阴性乳腺癌和HER-2过表达乳腺癌的临床病理特征比较

目的探讨三阴性乳腺癌和HER-2过表达乳腺癌的临床病理特征。方法选取210例雌、孕激素受体均为阴性的乳腺癌患者为研究对象，根据HER-2检测结果将其分为两组，三阴性乳腺癌组（Estrogen Receptor ER、Progesterone Receptor PR和HER-2表达阴性）85例，HER-2过表达乳腺癌组（ER、PR阴性和HER-2表达阳性）125例，比较两组发病部位、病理类型、肿瘤直径大小、淋巴结转移、组织学分级、TNM分期、p53表达及Ki-67表达情况。结果两组在发病部位上差异无统计学意义（P=0．4317），均好发于外上象限部位，分别占58．82％和46．4％；两组在病理类型、肿瘤直径大小、TNM分期、p53表达上差异无统计学意义（P=0．6146、P=-0．2744、P=0．5909、P=0．6002），其中浸润性导管癌、直径为2-5cm、II期所占比例均最高；三阴性乳腺癌组淋巴结转移以阳性为主，占56．47％，HER-2过表达乳腺癌组以阴性为主，占67．2％，差异有统计学意义（P=．0007）；两组在组织学分级上，差异有统计学差异（P=0．0278），其中组织学2级所占比例最高；三阴性乳腺癌组在Ki-67表达上与HER-2过表达组相比，有差异有统计学差异（P=0．0041）。结论三阴性乳腺癌和HER-2过表达乳腺癌的病理类型均好发在外上象限，以浸润性导管癌为主，就诊时均是II期病人为主。三阴性乳腺癌较HER-2过表达乳腺癌的侵袭性更强，细胞增殖更活跃，组织学分级更高，更易发生淋巴结转移，因此预后更差。

Clinical pathological features of triple-negatlve breast cancer and HER-2 overexpression breast cancer.

Objective To investigate the clinical pathological features of triple-negative breast cancer and HER-2 overexpression breast cancer. Methods A total of 210 patients with breast cancer of negative expression of estrogen and progesterone receptorses were selected as the research objects, which were divided into two groups according to the results of HER-2 detection： triple-negative breast cancer group （with negative expression of ER, PR and HER-2, n=85）, HER-2 overexpression breast cancer group （with negative expression of ER, PR and positive expression of HER-2, n=125）. The lesion site, pathological type, tumor size, lymph node metastasis, histological grade, TMN stage, P53 expression and Ki-67 expression of two groups were analyzed. Results There was no significant difference in lesion site between triple-negative breast cancer group and HER-2 overexpression breast cancer group （P=0.4317）, and the upper outer quadrant area occupied the highest ratio, about 58.82% and 46.4%. There was no sig- nificant difference in pathological types, tumor size, TMN staging, and P53 expression between triple-negative breast cancer group and HER-2 overexpression breast cancer group （P=0.6146, P=-0.2744, P=0.5909, P=-0.6002）, and the in- vasive ductal carcinoma, the tumor size （2-5 cm）, and stage II occupied the highest ratio. Lymph node metastasis with positive in triple-negative breast cancer group accounted for 56.47%, and lymph node metastasis with negative in HER-2 overexpression breast cancer group accounted for 67.2%. The differences was statically significant （χ2=11.609, P=0.0007）. The differences was statically significant in histological grade （P=-0.0278）, and histological grade II occupied the highest ratio. The differences was statically significant in Ki-67 expression between triple-negative breast cancer group and HER-2 overexpression breast cancer group （P=-0.0041）. Conclusion Triple-negative breast cancer and HER-2 overexpression breast cancer often occur in the upper outer quadrant area, and are mainly in invasive ductal carcinoma, and stage II. Triple-negative breast cancer is stronger in invasion, higher in histological grade, more apt to lymph node metastasis, and has a poorer prognosis than HER-2 overexpression in breast cancer.