三阴与非三阴性乳腺癌临床病理特征及预后比较

目的探讨三阴与非三阴性乳腺癌临床病理学特点，复发、远处转移和生存之间的差异，影响预后的因素。方法将2004年9月至2006年9月大连医科大学附属第二医院收治的有完整临床、病理和随访资料的手术乳腺癌387例分为三阴性乳腺癌组79例，非三阴性乳腺癌组308例，比较分析其临床病理特点及预后等。结果三阴性乳腺癌组：①年龄〈35岁的比例高（P=0．012）；②有乳腺癌家族史者比例大（P=0．031）；③肿瘤最大直径≥5cm多（P=0．044）；④确诊时淋巴结阳性者多（P=0．011）；⑤肿瘤临床分期为Ⅲ期的多（P=0．007）；⑥组织学分级为III级的多（P=0．028），5年无病生存率和总生存率分别为72．15％和88．61％，均低于非三阴性乳腺癌组的86．69％和95．45％（P值分别为0．003和0．031）。结论三阴性乳腺癌有发病年龄较轻、有乳腺癌家族史比例高、确诊时临床分期晚、淋巴结转移率高、肿瘤直径大、组织学分级高、易复发和远处转移、无病生存率和总生存率低等特点。患者年龄、肿瘤最大直径、确诊时淋巴结状态、肿瘤临床分期、组织学级别和病理类型，特别是年龄、淋巴结状态对判断预后有重要意义。

Comparison of clinicopathological features and prognosis in triple-negative and non triple-negative breast cancer

Objective To find out the incidence of triple-negative breast cancer（TNBC）in all kinds of breast cancers. To compare and analyze the clinicopathologieal features, recurrence, metastasis, and prognosis of patients with TNBC and non-triple negative breast cancer（non-TNBC）. Methods The elinicopathological fea- tures and follow-up data of 387 patients with primary breast cancer histopathologically confirmed in our hospital from Sep. 2004 to Sep. 2006 were retrospectively analyzed. The 387 patients were divided into 2 groups ：79 cases of TNBC and 308 cases of non-TNBC. The clinical features and prognosis of the 2 groups were compared. Results Compared with non-TNBC group, patients in TNBC group had their special features ： 1. higher ratio of patients 〈 35 years （ P = 0. 012 ） ; 2. higher ratio of patients with family history of breast cancer （ P = 0. 031 ） ; 3. higher ratio of tumors with maximum diameter ≥ 5 cm （ P = 0. 044） ; 4. higher ratio of patients with positive lymph nodes（P =0. 011 ） ; 5. higher ratio of tumors in clinical stage Ⅲ（P =0. 007） ; 6. higher ratio of tumors in histo- logical stage Ⅲ（ P = 0. 028 ）. The 5-year-disease-free survival （ DFS ） and overall survival （ OS ） rate for patients with TNBC were 72. 15% and 88. 61% respectively, lower than those of non-TNBC （P = 0. 003 and 0. 031 respectively）. Conclusions Compared with non-TNBC patients, patients with TNBC have the features of younger age, more advanced clinical stage upon diagnose, higher rate of lymph node metastasis, larger tumors, higher histological grade, faster and easier recurrence and metastasis, and lower rate of DFS and OS. The information of age, the maximum diameter of the tumor, lymph node status, clinical stage, histological grade and pathological types, especially the age and lymph node status, play an important role in predicting the prognosis of TNBC.