三阴性乳腺癌临床病理特点及与EGFR表达关系的探讨

The Relationship between the Clinicopathologic Characteristics of Triple Negative Breast Cancer and EGFR Expression

目的:研究三阴性乳腺癌的临床病理特点、预后及与EGFR表达的关系。方法:回顾性分析天津医科大学总医院1997年1月至2004年1月200例乳腺癌患者的临床资料,总结其病理特征及随访结果,并将200例病例对应的石蜡标本制作成组织芯片,用免疫组织化学法检测乳腺癌组织中ER、PR、HER-2的表达,进行乳腺癌分子分型。检测EGFR蛋白的表达,分析其与乳腺癌病理特征及预后的关系。结果:200例乳腺癌患者中三阴性乳腺癌42例(21.00%),在患者年龄、肿瘤大小、临床分期、淋巴结状态等病理参数的分析中,三阴性乳腺癌与非三阴性乳腺癌的分布无明显差异,而在绝经状态及肿瘤组织学分级的分析中,三阴性乳腺癌与非三阴性乳腺癌差异有统计学意义(P<0.05)。三阴性乳腺癌患者中17例死亡(生存率59.52%),非三阴性患者26例死亡(生存率83.54%),二者有显著性差异(P<0.05)。EGFR在三阴性乳腺癌中表达率较高(69.05%),与肿瘤组织学分级及淋巴结转移密切相关,且表达EGFR的三阴性乳腺癌患者生存时间较短。结论:三阴性乳腺癌发病率虽然不高,但其与常规的乳腺癌预后相关因素缺乏特定联系,患者预后差。EGFR在三阴性乳腺癌中高表达,可作为三阴性乳腺癌的一个重要的预后指标,并为临床提供了治疗的靶点。

Objective： To study the clinicopathologic characteristics and the prognostic factors of triple negative breast cancer, and to study the correlation between clinicopathologic features and EGFR expres sion. Methods： Clinical characteristics and prognosis of 200 breast cancer patients diagnosed between 1997 and 2004 were reviewed. The paraffin embedded tissues were selected and tissue microarray blocks were made. Immunohistochemical staining was used to evaluate the expression of ER, PR and HER2 for breast cancer molecular type. EGFR expression was evaluated to analyze its correlation with the clinical characteris tics and prognosis. Results： Fourty-two cases （21%） of 200 were triple negative breast cancer （TNBC）. There was no significant difference between TNBC and non-TNBC in clinicopathologic parameters such as age, tu mor size, clinical stage, and lymph node status. However, there was significant difference in histological category and menostasis status between the two groups （P〈0.05）. Among TNBC, 17 of 42 died during the follow-up （the overall suivival rate was 59.52%）, while 26 of 158 non-TNBC died （the overall survival rate was 83.54%）. EGFR was significantly overexpressed in TNBC （69.05%） and it was associated with lymph node status and histological category. Conclusion： Although the incidence of TNBC is low, it has a poorer prognosis than other subtypes. EGFR is highly expressed in TNBC and may serve as a prognostic index and an important therapatic target for breast cancer.