124例三阴性乳腺癌临床病理因素与预后分析

目的:三阴性乳腺癌（triple-negative breast cancer，TNBC）预后差，易复发转移，缺乏有效的治疗手段。本文回顾性分析TNBC及基底细胞型的临床病理因素与预后的关系。方法:纳入江苏省肿瘤医院124例TNBC，Fisher法分析临床病理因素之间的相关性，Kaplan-Meier法分析Ki-67/p53与无进展生存期的相关性，COX回归模型分析无进展生存期的预后因素。结果:TNBC肿块大小与腋窝淋巴结转移相关，Ki-67高表达与腋窝淋巴结转移相关，p53阳性与病理分级相关。TNBC及基底细胞型中，Ki-67高增殖与p53阳性患者具有相对较差的无病生存期（P＜0.05）。临床分期、腋窝淋巴结转移阳性、Ki-67高增殖与p53阳性是TNBC无病生存的独立预后因素。结论:本文证实Ki-67及p53是TNBC生存预后的预测因子，为TNBC延长生存、改善预后提供依据。

Retrospective analysis of clinic-pathological prognostic factors of 124 triple-negative breast cancer patients

Objective:Triple-negative breast cancer(TNBC) is an aggressive subgroup of breast cancer with poor prognosis,high recurrence and metastasis rate,lack of effective target therapy.This study was to investigate the TNBC and base-like subgroup clinic-pathologic prognostic factors retrospectively.Methods:124 cases of TNBC patients treated in Tumor Hospital of Jiangsu Province were enrolled in the research.Fisher precise method was used to examine the association between clinical characteristics.Kaplan-Meier method was performed to examine the association between p53/Ki-67 and disease free survival time(DFS) in TNBC and base-like subgroup.Univariate and multivariate analyses of COX model were used to distinguish the independent prognosis factors of DFS（disease free survival）.Results:Base-like subgroup accounted for 48.3 % of TNBC.p53 was positive in 46.8% and the Ki-67 high index was in 55.6% of TNBC.Positive p53 was associated with histological grade and high Ki-67 with lymph node metastasis.Lymphatic metastasis，serious clinical stage，positive p53 and Ki-67 high index significantly associated with high risk of recurrence and poor DFS of TNBC and base-like subgroup.Conclusion:This study indicated that lymphatic metastasis,clinical stage,p53,Ki-67 may be prognostic factors in TNBC.