三阴性乳腺癌的临床病理特征及生存分析

Clinicopathological features and outcomes of triple-negative breast cancer

目的研究三阴性乳腺癌(triple-negative breast cancer,TNBC)癌患者临床病理特征及影响预后的因素。方法收集2005年1月至2008年11月间南京军区福州总医院收治的579例浸润性乳腺癌患者的临床资料,分为非三阴性乳腺癌组和三阴性乳腺癌组,回顾性研究比较其临床病理特征并进行生存分析。结果 579例乳腺癌患者中91例(15.72%)患者是三阴性乳腺癌。三阴乳腺癌组和非三阴乳腺癌组相比较,平均年龄较小,分别为(48.63±10.81)岁和(51.32±11.47)岁;平均肿块较大,分别为(27.86±11.32)mm和(24.43±13.24)mm,两者均具有显著性差异(P<0.05)。两组相比较,三阴乳腺癌组绝经前比例较高(P=0.011),有乳腺肿瘤家族史比例亦高(P=0.020)。三阴性乳腺癌的5年无远处转移生存率为(66.28%),低于非三阴性乳腺癌组(80.85%,P<0.05);三阴性乳腺癌的5年总生存率(73.26%)明显低于非三阴性(84.04%,P<0.05)。而两者的病理类型、病理分级、淋巴结转移状况和肿瘤分期之间差异无显著性(P>0.05)。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。结论三阴性乳腺癌为一种独特的乳腺癌亚型,发病年龄较轻、肿块较大、绝经前比例高,预后差、缺乏特异性治疗。

Objective To compare the clinicoathological features and outcomes of triple - negative breast cancer（ triple - negative breast cancer, TNBC） with those in other types of breast cancer. Methods Totally 579 patients with infiltra-ting breast cancer have been treated from January 2005 to November 2008 in our hospital were retrospectively studied and were divided into group with triple - negative disease and group without triple - negative disease. The clinicopathologieal features were compared and the survival was analyzed in the two groups. Results Of 579 patients,91 （ 15.72% ） had tri-ple negative breast cancer. 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（48.63±10. 81 ）years vs. （51.32 ±11.47 ）years and（27.86 ± 11.32） nml vs. （24.43 ± 13.24） ram, （P 〈 0. 05）. Compared two groups, the TNBC group was higher in pre - menopausal proportion （ P = 0. 011 ） ; Itg proportion of family history of breast tumors was also high （ P = O. 020）. Five years of the TNBC group without distant metastasis free survival rate （66. 28% ） was significantly lower than the non-TN-BC group （80. 85%, P 〈 0. 05） ; The TNBC group 5 -year overall survival （73.26%） was significantly lower than that of non -triple negative （84. 04%, P 〈 0. 05 ）. But there were no significant differences between the two groups in pathologi-cal types, lymphatic spread,and tumor staging. Univariate and muhivariate 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 a special subtype of breast cancer, is more likely to occur in younger age and to have larger tumor size, higher proportion of pre-menopausal ,poor prognosis, lack of specific treatment.