三阴性乳腺癌的临床病理特征及生存分析

The clinicopathological features and outcomes of triple-negative breast cancer

目的:研究三阴性乳腺癌[雌激素受体(ER)、孕激素受体(PR)与人类表皮生长因子受体2(Her-2)均阴性]患者临床病理特征及预后特点。方法:回顾性研究554例浸润性乳腺癌患者的临床资料,分为三阴性乳腺癌组和非三阴性乳腺癌组,比较其临床病理特征并进行生存分析。结果:三阴性乳腺癌组和非三阴性乳腺癌组的平均年龄分别为(48.0±10.0)岁和(51.4±10.5)岁,差异有显著性(P=0.006),平均肿块大小分别为(28.0±12.6)mm和(24.6±11.2)mm,差异有显著性(P=0.011)。而两者的病理类型、淋巴结转移状况和肿瘤分期之间差异无显著性。单因素和多因素分析均表明三受体阴性是总生存率和无远处转移生存率的影响因素。结论:跟非三阴性乳腺癌患者相比,三阴性乳腺癌患者年龄较轻、肿块较大、远处转移早、预后差、缺乏特异性治疗,需要研究针对性的治疗方案。

Objective To compare the clinicopathological features and outcomes of triple-negative breast cancer [estrogen receptor （ER）, progesterone receptor （PR）, and human epidermal growth factor receptor-type 2 （Her-2） negative] with those in other types of breast cancer. Methods 554 patients with infiltrating breast cancer were retrospectively studied and were divided into group with triple-negative disease and group without triple- negative disease. The clinicopathological features were compared and the survival was analyzed in the two groups. Results The mean age at diagnosis and the mean tumor size differed significantly between the group with triple- negative disease and the group without triple-negative disease [（48.0 ± 10.0） years vs. （51.4 ± 10.5） years and （28.0 ± 12.6） mm vs. （24.6 ± 11.2） mm, P = 0.006 and P = 0.011]. There were no significant differences between the two groups in pathological types, lymphatic spread, and tumor staging. Univariate and multivariate analysis both indicated that triple-negative was a significant prognostic factor for the distant metastasis-free survival and overall survival. Conclusions Triple-negative breast cancer, as compared with other types of breast cancer, is more likely to occur in younger women and to have larger tumor sizes, earlier metastases, and poorer prognosis. Further studies should be conducted to find more effective therapies for the malignancy due to the lack of specific treatment.