三阴乳腺癌患者的临床病理特征及预后因素分析

An analysis of clinical characteristics and prognosis of triple-negative breast cancer

目的研究三阴乳腺癌(TNBC)临床病理特征与预后的相关性。方法收集52例TNBC和109例非三阴乳腺癌(non-TNBC)患者术后临床病理资料,分析TNBC和non-TNBC临床病理特征的差异性,分析两者间5年无疾病生存期(DFS)和总生存期(OS)的差异性,分析52例TNBC临床病理特征与预后的相关性。结果 TNBC患者≤35岁为13例(25.0%),比例高于non-TNBC11.9%,差异有统计学意义;TNBC 98.0%为浸润癌,其发生率明显高于non-TNBC 67.0%(P<0.05);TNBC出现大肿块(直径≥5 cm,50.0%)及脉管转移(59.6%)均高于non-TNBC(33.9%与36.7%),差异有统计学意义(P<0.05);TNBC与non-TNBC淋巴结转移数目之间差异无统计学意义(P>0.05)。TNBC 5年无疾病生存率38.0%,non-TNBC 5年无疾病生存率64.0%,两者之间的差异有统计学意义(P<0.05);TNBC 5年总生存率62.0%低于non-TNBC 5年总生存率91.0%(P<0.05)。TNBC患者发病年龄、淋巴结转移数目为预测5年DFS和OS的独立预后因素。结论 TNBC发病年龄小,侵袭性强,预后差,其发病年龄及腋淋巴结转移个数可作为判断预后的独立因素,对于年龄小、存在淋巴结转移的TNBC患者需给与足够的重视,进行严格系统的治疗。

Objective To analyze the clinic pathological characteristics and prognosis of triple - negative breast cancer. Methods Thepathological and clinical data of 52 TNBC and 109 non - TNBC patients were collected between Jan. 2004 and Jan. 2009. The TNBC and non -TNBC incidence age, size of tumors,lymphnode metastasis, pathological type and vascular metastasis was analyzed. The difference of the five years disease free survival （DFS） and overall survival （OS） between triple negative breast carcinoma （TNBC） and non triple negative breast carcinoma （non -TNBC） were estimated by Kaplan Meier. The relationship between patientsiaathological and clinical and prognosis was analyzed by Multivariate Coxmodel. Results TNBC patients were in younger group （aged less than 35 years old） of morbidity than non - TNBC （ 25.0% vs. 11.9%, P 〈 0.05 ）. TNBC infiltrating incidence of ductal carcinoma was obviously higher than non - TNBC＇s （98.0% vs. 67.0% ,P 〈 0.05 ）. TNBC in size （ 〉 5era） had higher frequency than non - TNBC （ 50.0% vs. 33.9% ,P 〈0.05）. TNBC in vascular metastasis had higher frequency than non - TNBC （59.6% vs. 36.7% ）. TNBC was statistically reduced associated with 5 years DFS （38.0% vs. 64.0% ） and OS （62.0% vs. 91.0% ,P 〈 0.05 ）. Pateints incidence age and lymph nodestatus provided independent significant predictive power. Conclusion TNBC patients are mainly in younger group of morbidity, and more infiltrating, the patients with triple - negative breast cancer have worse prognosis. Pateints incidence age and lymph nodestatus pro- vide independent significant predictive power, so the young and the lymph node metastasis in patients need to strengthen operation and se- lective chemotherapy.