三阴性乳腺癌210例临床分析

目的探讨三阴性乳腺癌（triple-negative breast cancer，TNBC）病人的临床病理特征、预后及其影响因素。方法收集2010年9月至2015年9月收治的TNBC病人210例，并选取同期治疗的非TNBC病人70例作为对照，对其临床资料进行回顾性分析。结果肿瘤大小与淋巴结转移有关，肿瘤长径越大，淋巴结转移率越高（P < 0.01）。超声及钼靶检查对TNBC病理诊断的相符率比较，联合诊断相符率94.76%最高（P < 0.01），超声诊断相符率84.76%次之（P < 0.01），钼靶诊断相符率70.00%最低（P < 0.01）。观察组病理组织学分级高于对照组（P < 0.01）。预后分析表明，观察组复发率42.38%高于对照组28.57%，观察组生存率74.29%低于对照组85.71%（P < 0.05）。肿瘤长径越大，生存率越低（P < 0.01）。淋巴结阴性者存活率86.00%，高于淋巴结阳性者存活率65.45%（P < 0.01）。结论与非TNBC相比，TNBC肿瘤长径大、发病年龄低、病理组织学分级高，更易复发和转移，预后更差。超声和钼靶是TNBC辅助诊断的有效检查，二者联合诊断符合率更高。肿瘤长径较大和淋巴结阳性是TNBC死亡的危险因素。

The clinical analysis of 210 cases of triple-negative breast cancer

ObjectiveTo investigate the clinicopathologic characteristics, prognosis and its risk factors of triple-negative breast cancer(TNBC).MethodsThe clinical data of 210 patients with TNBC(observation group) and 70 non-TNBC patients(control group) from September 2010 to September 2015 were retrospectively analyzed.ResultsThe lymph node metastasis rate was related to the tumor size, and the larger the tumor size, the higher the lymph node metastasis rate was(P < 0.01).Compared with the coincidence rate of pathological diagnosis of ultrasound or mammography, the coincidence rate of combined diagnosis was the highest(97.46%)(P < 0.01), and the coincidence rates of ultrasound and mammography were 84.76% and 70.0%, respectively(P < 0.01).The pathological histological classification in observation group was higher than that in control group(P < 0.01).Prognostic analysis showed that the recurrence rate and survival rate in observation group(42.38%, 74.29%) were higher and lower than those in control group(28.57%, 85.71%) respectively(P < 0.05).The larger the tumor size, the higher the lymph node metastasis rate was(P < 0.01).The survival rate in patients with negative lymph node(86.00%) was higher than that in patients with positive lymph node(65.45%)(P < 0.01).ConclusionsCompared with the non-TNBC, the tumor size is large, the age of patient is young, the pathological histological classification is high, the relapse and metastasis are ease, and the prognosis is poor in TNBC.Ultrasonography and mammography are the effective methods in auxiliary diagnosis of TNBC, and the correct rate of combination of both methods is higher.Larger tumor size and lymph node metastasis are the risk factors of TNBC death.