三阴乳腺癌临床病理特点及预后分析

Clinicopathologic features and prognosis of triple negative breast cancer

目的探讨三阴乳腺的临床病理特征及预后。方法回顾性分析我院2004年1月-2007年12月外科收治的病理确诊的89例乳腺癌患者资料,根据雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（Her-2）的表达,将其分为2组：三阴组（ER阴性、PR阴性、Her-2阴性）、非三阴组,比较2组患者的发病时月经情况、肿瘤部位、肿瘤大小、病理类型、淋巴结转移、临床病例分期、治疗结果和随访情况。结果 2组患者肿瘤直径大小、病理类型、TNM分期、淋巴结转移情况上差异无统计学意义（P〉0.05）,其中浸润性导管癌所占比例最高,分别为85.2%、83.9%,肿瘤直径2-5 cm所占比例最高,分别为48.1%、53.2%;II期患者比例最高,分别为44.4%、51.6%;三阴乳腺癌患者绝经前确诊比例较非三阴乳腺癌组患者高,差异有统计学意义（P〈0.05）;2组患者在Ki-67表达上差异有统计学意义（P〈0.05）。随访情况与非三阴乳腺癌患者比较,三阴乳腺癌组患者局部复发、远处转移多见,差异有统计学意义（P〈0.05）,死亡比例差异无显著性（P〉0.05）。结论三阴乳腺癌与非三阴乳腺癌均以浸润性导管癌为主,肿瘤多在2-5 cm,就诊时均以II期患者为主,淋巴结转移率接近。三阴乳腺癌较非三阴乳腺癌发病年龄更小,多在绝经前确诊,组织学分级更高,细胞增殖更活跃,更易出现复发、转移。

Objective To investigate clinical pathological features and prognosis of triple negative breast cancer（ TNBC）.Methods 89 cases of breast cancer hospitalized in our hospital between January 2004 and December 2007 were retrospectively analyzed. The patients were divided into two groups according to the expressions of estrogen receptor（ ER）,progesterone receptor（ PR） and human epidermal growth factor receptor 2（ Her-2） ： TNBC group（ ER negative,PR negative and Her-2 negative） and non-TNBC group（ the other patients）. The two groups were compared in terms of the incidence of menstrual status,location and size of the tumor,pathological type,lymph node metastasis,clinical stage,treatment outcome and follow-up information. Results There was no statistical difference between the two groups in terms of tumor size,pathological type,TNM stage,and lymph node metastasis（ P〉0. 05）. Of all the cases,the incidence of infiltrating ductal carcinoma was the highest,accounting for 85. 2% and 83. 9% respectively; the tumor diameter of 2 - 5cm took the highest proportion,with 48. 1% and 53. 2%respectively; stage II occurred in most patients,with the highest rate of 44. 4% and 51. 6% respectively. The proportion of the TNBC group patients diagnosed before menopause was higher than in the non-TNBC group patients. The difference was statistically significant（ P〈0. 05）. The two groups showed statistical difference in the Ki-67 expression（ P〈0. 05）. Statistical difference was seen in the follow-up between the two groups,with more local recurrence and distant metastasis in the TNBC group than in the non-TNBC group（ P〈0. 05）. As for the ratio of death,there was no significant difference between the two groups（ P〉0. 05）. Conclusion TNBC group and non-TNBC group are both dominated by infiltrating ductal carcinoma. Tumors are mainly 2 - 5cm in diameter. Stage II patients compose the main proportion,with almost the same rate of lymph node metastasis.The age of onset of TNBC tends to be younger than that of non-TNBC. The histological grade is higher,the cell proliferation is more active,and relapse and metastasis are more prone to occur.