137例术后三阴性乳腺癌的临床特征及预后分析

目的:分析三阴性乳腺癌(TNBC)病例资料,探讨术后辅助治疗的三阴性乳腺癌的临床特点及预后。方法:收集2003年5月至2008年12月在苏州大学附属第一医院的137例术后TNBC的临床资料,进行回顾分析,研究其临床特征、生存情况、治疗效果。结果:137例患者确诊为三阴性乳腺癌时中位年龄50岁,为术后I至III期病人,浸润性导管癌131例(95.6%);肿瘤直径≥5cm者24例(17.5%);区域淋巴结阳性者70例(51.1%)。中位随访时间63个月(34-100个月)。5年无病生存率(DFS)为59.1%。以蒽环类为基础的辅助化疗方案5年无病生存率(63.6%)高于CMF方案(37.5%)(P=0.038)。单因素预后分析显示肿块大小、淋巴结转移数目、辅助化疗周期数、化疗方案与TNBC的预后有关(均P<0.05)。多因素分析显示,淋巴结转移数目是影响TNBC预后的独立因素(P<0.05)。结论:三阴性乳腺癌具有独特的临床病理特点,其辅助治疗效果仍需要进一步探讨研究。

Clinical characteristics and prognosis of 137 postoperative triple- negative breast cancer patients

Objective:To study the clinical features and prognosis of patients with triple-negative breast cancer(TNBC) who received postoperative adjuvant therapies.Methods: Between May 2003 and December 2008,a total of 137 TNBC patients who received surgical procedure were included in this study.The clinical features,long-term survival and treatment outcomes were retrospectively evaluated.Results: The median age of the 137 patients varying from clinical stage I to III was 50 years old.Among the 137 patients,95.6% had invasive ductal carcinomas,7.5% was classified over T3,and 51.1% was with positive lymph nodes.The median follow-up period was 63 months(34-100 months),and the 5-year disease-free survival(DFS) was 59.1%.The 5-year DFS of patients treated with anthracycline-based regimens was higher than those treated with the regimens containing cyclophosphamide,methotrexate,and fluorouracil(P=0.038).The tumor size,lymph nodes status,the number of the adjuvant chemotherapy cycles,and chemotherapy regimens were correlated with DFS by univariate analysis.Furthermore,lymph nodes status was demonstrated to be an independent prognostic factor by multivariate Cox regression analysis.Conclusion: TNBC has distinctive clinicopathological features.