雌、孕激素受体和Her-2阴性乳腺癌的临床病理特征

Clinicopathologic characteristics of triple-negative breast cancer

目的评价雌、孕激素受体和Her-2表达均阴性乳腺癌（triple-negative breast cancer，TNBC）的临床病理特征及其对预后的影响。方法500例乳腺癌采用免疫组化筛选TNBC，观察TNBC的临床病理特征，并对其中243例乳腺癌进行临床随访。结果500例乳腺癌中TNBC占17．6％（88／500）。组织学类型主要为浸润性导管癌（NOS）、化生性癌和髓样癌。组织分级Ⅲ级占72．7％（64／88），高于激素受体阳性组和Her-2高表达组（P=0．000）。TNBC中CK5／6阳性率30．7％（27／88），EGFR阳性率34．1％（30／88）。TNBC中ERCC1和KIT阳性率分别为28．4％（25／88）和34．1％（30／88），均分别高于激素受体阳性组和Her-2高表达组（P=0．032和P=0．026）。TNBC3年累积生存率为71．5％，低于激素受体阳性组（P=0．021），与Her-2高表达组差异无统计学意义（P=0．474）。结论TNBC是～类具有高侵袭性病理特征和预后不良的乳腺癌；部分病例表达EGFR和ERCC1。

Objective To study the clinicopatbologic characteristics of triple-negative breast cancer （TNBC） and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochemically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% （88/500） of the 500 breast cancers. The histological types of the TNBC included mainly infiltrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72. 7% （64/88） of all the TNBC and was more common than that in hormone receptor positive breast cancers （HR ＋ group ） and Her-2 overexpression breast cancers （Her-2 group） （P = 0. 000）. The positive rates of CK5/6 and EGFR in the TNBC were 30.7% （27/88） and 34. 1% （30/88）, respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% （25/88） and 34. 1% （30/88）, respectively, Both of which were higher than those in the HR ＋ group and Her-2 group, respectively （ P = 0. 032 and P = 0. 026 ）. 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group （ P = 0. 021 ） and not significantly different from that of Her-2 group （P = 0. 474）. Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.