三阴乳腺癌与非三阴乳腺癌预后的比较分析

目的 比较三阴乳腺癌与非三阴乳腺癌预后的不同及其影响因素.方法 回顾性分析1998年12月至2007年6月收治的684例临床可手术乳腺癌患者的临床资料,其中107例为三阴乳腺癌患者(三阴组),577例为非三阴乳腺癌患者(非三阴组).应用Kaplan-Meier法进行生存分析,组间比较用log-rank检验,多因素分析采用COX比例风险模型.结果 三阴组与非三阴组总的7年生存率分别为51.4%(55/107)及74.2%(428/577),差异有统计学意义(P＜0.01).Her-2表达阳性患者总的7年生存率为53.1%(43/81),与三阴组比较差异无统计学意义(P＞0.05).单因素分析结果显示患者的年龄、月经状态、肿瘤大小、腋窝淋巴结状态及受体状况均为预后影响因素.多因素分析结果表明肿瘤大小、腋窝淋巴结状态及受体状况为预后的独立影响因素.结论 三阴乳腺癌和Her-2表达阳性的乳腺癌患者治疗效果均较差,三阴乳腺癌是一个独立的预后影响因素.

Comparison of survival in patients with breast cancer of triple-negative versus non-triple-negative

Objective To assess whether survival differed among patients who had triple-negative breast cancers compared with patients who had non-triple-negative breast cancers.Methods The clinicopathologic data of 684 patients with operable breast cancer,who were treated with multimodal therapy from December 1998 to June 2007 were analyzed.Of these patients,107 cases were confirmed to have triple-negative tumor histology(triple-negative group),577 cases were confirmed to have non-triple-negative tumor histology(non-triple-negative group).The 7 years cumulative survival and disease-free survival were analyzed by Kaplan-Meier method and compared by Log-rank test.The prognosis Was analyzed by COX regression model.Results The 7 years overall survival rates for triple-negative group and non-triple-negative group were 51.4%(55/107),74.2%(428/577),respectively,there Was significant difference between the two groups(P＜0.01).However,the 7 years overall survival rates of patients with triple-negative group and those who with Her-2 positive were 51.4%(55/107)and 53.1%(43/81)respectively,there Was no significant difference between them (P＞0.05).Univariate analysis revealed that the factors affecting the disease-free survival included age,menopausal status,tumor size,lymph nodes metastasis,estrogen,progesterone,and Her-2 receptors status.Multivariate analysis showed minor size,lymph nodes metastasis,estrogen,progesterone,and Her-2 receptors status were independent prognostic factors.Conclusions This study has shown a trend towards a poorer outcome for patients with triple-negative breast cancer similarity to patients with Her-2 positive cancers.Triple-negative breast cancer is an independent predictor factor of survival.