三阴性乳腺癌和非三阴性乳腺癌临床特征的比较

目的 比较三阴性和非三阴性乳腺癌的临床特征,丰富三阴性乳腺癌的防治资料,为乳腺癌的个体化综合治疗寻找理论依据.方法 回顾性分析2002年收治的乳腺癌患者病例,选择接受手术治疗、资料完整并经免疫组织化学方法明确判定受体状况的408例患者进行分析.通过与非三阴性乳腺癌的比较,分析三阴性乳腺癌的临床特征、复发及生存情况.结果 本组资料中确认三阴性乳腺癌77例,占乳腺癌患者的18.9%(77/408).所有患者中位随访64个月(3～79个月).408例病例中,复发或转移58例,死亡51例,三阴性乳腺癌中复发或转移19例,死亡12例.三阴性乳腺癌患者的年龄较轻,肿瘤体积较大,局部复发率和远处转移率均显著性高于非三阴性乳腺癌患者(P均<0.05).生存分析显示,三阴性乳腺癌患者的3年和5年总生存率(86.4%和77.7%)均显著低于非三阴性乳腺癌患者(93.4%和87.9%)(P均<0.05);三阴性乳腺癌患者的3年和5年无病生存率(78.4%和72.8%)均显著低于非三阴性乳腺癌患者(92.4%和85.8%)(P均<0.05).结论 三阴性乳腺癌具有特定的临床特征,预后比非三阴性乳腺癌差,需要进一步开展三阴性乳腺癌的个体化治疗的研究.

Clinical characteristics comparison between triple-negative and non-triple-negative breast cancer

Objective To compare the clinical characteristics of triple-negative (TN) breast cancer and non-triple-negative(NTN) breast cancer, enrich the information of TN patients, and provide evidences for individualized combined treatment. Methods The data of 408 cases received operation in the year of 2002 was enrolled in this study. TN patients were confirmed according to the immunohistochemical (IHC) test of estrogen receptor ( ER), progesterone receptor (PR) and HER-2/neu. The clinical characteristics, recurrence, metastasis and survival were compared between the two groups. Results Seventy-seven patients ( 18.9% ) were confirmed TN cases. The median follow-up was 64 months ( range, 3-79 months). Of all the cases, 58 occurred local recurrence or metastasis and 51 died, it was 19 and 12 in TN group. Compared with the NTN group, the TN patient tended to be younger and the tumor mass larger ( P = 0.015 and 0.011 ). However, axillary lymph nodes metastasis occurred more often in NTN patients than in TN patients (P =0.001 ). The rate of local recurrence and metastasis in TN group was significantly higher than in NTN group ( P = 0.005 and 0.025 ), and TN cases were more likely to develop lung metastasis than NTN patients (P <0.01 ). The 3-year and 5-year overall survival rate in TN group were significantly lower than in NTN group (86.4% vs. 93.4% , P =0.0205; 77.7% vs. 87.9%, P=0.0215). The 3-year and 5-year disease-free survival rate in TN group were also significantly lower than in NTN group (78.4% vs. 92.4%, P = 0.0038; 72.8% vs. 85.8%, P =0.0041 ). Tumor size, lymph node status and triple-negative were the most important factors influencing the prognosis on multivariate Cox regression analysis. Conclusions TN breast cancer haa some specific clinical characteristics. The prognosis of TN patients is worse than that of NTN patients. Further study is needed to find individualized treatment for TN breast caner patients.