淋巴结分类情况下不同类型三阴性乳腺癌的预后分析

Prognostic Analysis for Different Types of Three Negative Breast Cancer with Lymph Node Classification

目的探讨三阴性乳腺癌及基底细胞样乳腺癌与患者临床病理特征及预后的相关性。方法应用免疫组织化学(EnVision二步法)检测69例三阴性乳腺癌患者原发灶石蜡切片中CK5/6、CK14、CK17的表达情况,将其分成基底细胞样型(BP)和非基底细胞样型(NBP)两组;再根据患者淋巴结转移情况分成淋巴结阴性组和淋巴结阳性组,并分别分析基底标志物的表达及淋巴结转移情况与患者临床病理特征及预后的相关性。结果 40例患者(58.0%)是基底细胞样型。淋巴结阴性组中,BP患者肿瘤直径较大、EGFR阳性表达率较高、脉管癌栓阳性率较高、组织学分级与核分级较高,差异有统计学意义。且淋巴结阴性的BP患者较NBP患者远处转移及复发率较高,预后差。结论检测三阴性乳腺癌基底标记物的表达情况,并将其具体分型,对于临床制定三阴性乳腺癌患者个体化治疗方案及预后的判断是必要的。

Objective To investigate three negative breast cancer and basal-like breast cancer patients with clinical pathologic characteristics and prognosis of relevancy. Methods All of the 69 patients were proved to be triple-negative by immunohistochemical screening or FISH testing. Immunohtstochemteal staining was performed for the CK5/6, CK14, and CK17 basal markers in 69 patients for the purpose of classifying as basal or non-basal phenotype, and classify the TNBC on the basis of being positive or negative for lymph node metastasis, then the clinicopathological features and outcome of the patients was analyzed. Re- sults Forty patients （58. （）~） were the BLBC. In the node-negative group,compared with the NBP,the BP were significantly larger in tumor size, and were higher in incidence of EGFR-positive, incidence of vascular invasion,grade of histology and nuclear,and showed a higher incidence of recurrence and distant metastasis. Conclusion It is required to test for basal marker expression and Classify TNBC, this will aid in deciding the therapeutic strategy and prognosis for triple-negative breast cancer.