保乳手术治疗三阴乳腺癌的疗效观察

目的：探讨保乳手术治疗三阴乳腺癌的安全性及临床预后特点。方法157例乳腺癌患者根据其受体表达情况分为非三阴乳腺癌组（非三阴组，n＝76）和三阴乳腺癌组（三阴组，n＝81），比较两组临床病理特征、术后5年局部复发、远处转移及生存情况。结果三阴组年龄＜35岁患者占17．3％，显著高于非三阴组的7．9％（χ^2=5．331，P＜0．05）；三阴组肿瘤大小≥5 cm患者占79．0％，显著高于非三阴组的59．2％（χ^2=7．022，P＜0．05）；三阴组有家族史和淋巴结阳性患者分别占9．9％和28．4％，均显著高于非三阴组的2．6％和17．1％（χ^2=6．283、4．865，均P＜0．05）；两组局部复发率、远处转移率和5年总生存率差异均无统计学意义（χ^2=2．559、2．829、2．361，均P＞0．05）；三阴组5年无病生存率为80．2％，显著低于非三阴组的94.7％（χ^2=6．572，P＜0．05）。结论三阴乳腺癌患者发病年龄轻、肿瘤体积大、家族史比例高，行保乳手术后患者复发率、远处转移率和5年总生存率与非三阴组相当，安全性高，具有较好的临床应用价值。

Curative effects of breast conserving operation in treatment of triple negative breast cancer

Objective To investigate the safety and clinical prognosis of breast conserving operation in treat-ment of triple negative breast cancer.Methods 157 patients with breast cancer were divided into the non triple nega-tive breast cancer group （n=76） and triple negative breast cancer （n=81） according to its receptor expression,clin-ical pathological features, local recurrence after 5 years.Distant metastasis and survival situation were compared between two groups.Results The age〈35 years patients of triple negative group accounted 17.3%,significantly higher than 7.9%of the non triple negative group（χ^2=5.331,P〈0.05）;the size of tumor≥5cm of triple negative group accounted 79.0%,significantly higher than 59.2% of the non triple negative group（χ^2=7.022,P〈0.05）;The patients with positive family history and lymph nodes of the triple negative group were 9.9%and 28.4%,signifi-cantly higher than 2.6%and 17.1%of non triple negative group,the difference between the two groups was statisti-cally significant （χ^2=6.283,4.865,all P〈0.05）;The local recurrence,distant metastasis rate and 5 year survival rates between the two group were not significantly different（χ^2=2.559,2.829,2.361,all P〉0.05）;The 5 year dis-ease free survival rate of the triple negative group was 80.25%,significantly lower than 94.74%of the non triple neg-ative group （χ^2=6.572,P〈0.05）.Conclusion The patients with triple negative breast cancer is younger,their tumor size is large and has a high proportion of family history.Their recurrence rate,distant metastasis rate and 5 year overall survival rate are as better as the patients with non triple negative breast cancer after breast preservation opera-tion,which has high security and good clinical application value.