术后首发肺转移的三阴性乳腺癌临床病理特点及预后因素分析

目的:分析和探讨术后首发肺转移的三阴性乳腺癌患者的临床病理特点，以及可能影响生存的预后因素。方法:对71例术后首发肺转移三阴性乳腺癌患者的临床资料进行回顾性分析，通过COX分析影响总生存的预后因素。结果:71例术后首发肺转移三阴性乳腺癌患者中以浸润性导管癌为主（97.2%），术后中位无病间期为14.4个月，发生肺转移后的1、2、3年生存率分别为81.7%、45.1%、16.7%。单因素分析显示，新辅助治疗、原发肿瘤大小、淋巴结转移状态、临床分期、一线化疗最佳疗效、肺转移灶数目与预后相关（P＜0.05）。多因素分析显示，是否行新辅助治疗和肺转移灶数目是术后首发肺转移患者的独立预后因素（P＜0.05）。结论:术后首发肺转移三阴性乳腺癌患者术后无病间期短，远期生存率较低，是否行新辅助治疗和肺转移灶数目是影响术后首发肺转移患者转移后总生存期的独立预后因素。

Clinical characteristics and prognosis of triple-negative breast cancer patients with postoperative initial pulmonary metastasis

Objective:To analyze and discuss the clinicopathologic characteristics of triple-negative breast cancer with initial pulmonary metastasis after surgery,as well as the efficacy of the prognostic factors.Methods:A retrospective analysis was performed using the clinical data of 71 triple-negative breast cancer cases of postoperative initial pulmonary metastasis.The analysis also included their survival situation and prognostic factors.Results:Invasive duct carcinoma(97.2%) was predominant in 71 patients with triple-negative breast cancer with initial pulmonary metastasis after surgery.The postoperative median disease-free interval was 14.4 months.The 1-,2- and 3-year survival rates after visceral metastasis were 81.7%,45.1% and 16.7%,respectively.Univariate analysis showed that neoadjuvant chemotherapy,primary tumor size,lymph node metastasis status,clinical stage,best curative effect of first-line chemotherapy,and number of pulmonary metastasis had significant effects on the overall survival (all P＜0.05).Additionally,multivariate analysis showed that neoadjuvant chemotherapy and number of internal pulmonary transfer stoves had significant effects on overall survival (both P＜0.05).Conclusion:The triple-negative breast cancer patients with initial pulmonary metastasis have short disease-free interval time and low long-term survival rate.The neoadjuvant chemotherapy and number of pulmonary metastasis may be the independent prognostic factors for their overall survival.