年轻三阴性乳腺癌患者的临床病理特征及预后分析

目的 分析年轻三阴性乳腺癌(TNBC)患者的临床病理特征和预后因素.方法 1999年1月至2007年12月间,中国医学科学院肿瘤医院收治的年龄≤35 岁的年轻TNBC患者94例,所有患者肿瘤组织中雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(Her-2)均为阴性,收集患者的临床病理资料和生存情况,分析其临床病理特点和预后因素.结果 全组94例年轻TNBC患者,占同期收治年轻乳腺癌患者的12.0%.主要病理类型为浸润性导管癌,共81例,占86.2%.分期为Ⅰ、Ⅱ、Ⅲ和Ⅳ期的患者分别有17例(18.1%)、48例(51.1%)、28例(29.8%)和1例(1.1%).14例(14.9%)患者存在脉管瘤栓.全组94例患者的1、3、5和7年无病生存率(DFS)分别为88.3%、66.9%、59.7%和59.7%,1、3、5和7年总生存率(OS)分别为98.9%、85.6%、72.9%和69.6%.单因素预后分析结果显示,肿瘤大小、腋淋巴结状态、临床分期以及有无脉管瘤栓对年轻TNBC患者的5年OS具有显著影响(均P<0.05).多因素预后分析结果显示,有无脉管瘤栓是影响年轻TNBC患者预后的独立因素(P<0.05).在随访期出现复发和(或)转移的33 例患者中,29例发生于术后3年内,其余4例发生于术后3～4年间.结论 年轻TNBC 患者具有独特的临床、病理和预后特点,需要探索更为合理的个体化治疗方案.

Clinicopathological characteristics and prognostic significance of young patients with triple-negative breast cancer

Objective To investigate the clinicopathological characteristics and prognosis in young patients with estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and Her-2-negative (triple-negative) breast cancer (TNBC). Methods 94 young patients( ≤35 years old) with TNBC at the Cancer Hospital of CAMS between January 1999 and December 2007 were included in this study. The clinicopathological features and prognosis of those 94 patients were retrospectively evaluated. Results Among786 young patients with breast cancer, 94 patients (12.0%) were triple-negative. The median age of the 94young TNBC patients was 31 years. 81 patients (86.2%) were diagnosed with invasive ductal carcinoma.82.0% of the patients were classified as T1 or T2. The TNM stages included: 17 patients in stage Ⅰ(18.1%), 48 in stage Ⅱ (51.1%), 28 in stage Ⅲ (29.8%) and 1 in stage Ⅳ (1.1%). 14 patients(14.9%) were diagnosed with lymphovascular invasion. The 1-, 3-, 5-and 7-year disease-free survival(DFS) was 88.3%, 66.9%, 59.7% and 59.7%, respectively. The corresponding overall survival (OS)rate was 98.9%, 85.6%, 72.9% and 69.6%, respectively. The univariate analysis showed that T stage,lymph node metastasis, clinical stage and lymphovascular invasion were correlated with the overall survival.However, only vascular invasion was showed to be an independent prognostic factor assessed by multivariateanalysis. 33 patients developed recurrence or metastatic TNBC during the follow-up period. Among those 33eases, 29 had recurrent or metastatic diseases within 3 years postoperatively and the other 4 cases after 3years following surgery. Conclusion Young patients with TNBC represent distinctive clinicopathologicaland prognostic characteristics. Progression on tailored treatment for such population is still crucial. Furtherstudies on rational individualized treatment regimen are warranted.