132例三阴性乳腺癌患者的临床特征与预后分析

Clinical characteristics and prognosis of triple negative breast cancer in 132 cases

目的探讨三阴性乳腺癌的临床特征及影响预后的因素。方法采用回顾性方法对我院132例三阴性乳腺癌患者的临床特征进行分析，并根据随访资料分析了患者的生存情况及预后因素。所有患者均经免疫组化证实ER、PR、Her-2为阴性。结果132例三阴性乳腺癌患者占同期乳腺癌患者（774例）的17．1％，绝经前患者（91例）占68．9％，53．8％的患者（71例）发病时肿块大小为T2，39．4％患者（52例）腋窝淋巴结阳性。中位随访时间63个月，共有33例出现复发或转移，其中20例死亡，23例同时出现2个部位以上的转移，5年的无病生存率为73．8％，总生存率为85．7％。淋巴结阳性患者复发转移风险较淋巴结阴性患者明显增加（P=0．001）。结论三阴性乳腺癌患者大多在治疗后2—3年发生多发转移，仅淋巴结状况是影响其预后的重要因素，淋巴结阳性的三阴性乳腺癌患者预后差。

Objective To study the clinical characteristics, and the prognostic factors of triple negative breast cancer. Methods 130 triple negative breast cancer patients were reviewed on clinical eharacteristies and prognosis. All eases were lack of expression of estrogen receptor, progesterone receptor, and Her - 2/neu determined by immunohistoehemistry. Results 17.1% of all breast cancer patients （774 cases ） were triple negative breast cancer, and 68.9% of triple negative breast cancer patients（91 cases）were premenopausal. 53.8% of patients（71eases）had the tumors with T2 size,and 39.4% of them（52 patients）had lymph node metastasis. The rate of relapse in patients with lymph node metastasis was obviously higher than that in patients without lymph node metastasis（P = 0. 001 ）. The median time of follow- up was 63 months. 33 cases relapsed and 20 patients had died. 23 patients had at least two organs metastasis. The 5 - year disease - free and overall survival rates were 73.8% and 85.7% ,respectively. Conclusion Triple negative breast cancer patients commonly have high rate of multiple distant metastasis in 2 - 3 years after treatment. The status of lymph node is the most important prognostic factor. The triple negative breast caner patients with lymph node metastasis have poor prognosis.