108例三阴性乳腺癌临床特征分析

Analysis of clinical characteristics of 108 triple negative breast cancer patients

目的观察和分析三阴性乳腺癌患者的基本临床特征。方法采用回顾性队列研究,分析总结三阴性乳腺癌患者的临床特征,并与HER-2阳性患者进行比较。结果共108例三阴性和53例HER-2过表达乳腺癌术后患者纳入研究。三阴性乳腺癌患者平均年龄47岁左右,主要术式为改良根治术,主要病理类型为浸润性导管癌,36.1%的患者腋下淋巴结阳性,49.3%的患者Ki67阳性,术后转移8例(7.4%)。与HER-2过表达患者比较,三阴性乳腺癌患者年龄低,更偏向于选择保乳术,Ki67表达水平高。三阴性乳腺癌主要中医临床特征表现为虚实夹杂,虚证为气阴两虚和冲任失调,实证为痰浊、血瘀、毒结等,三阴性和HER-2过表达乳腺癌患者中医临床特征相似。结论三阴性乳腺癌患者临床特征与HER-2过表达乳腺癌患者有所差异,但中医临床表现两者相似,提示在临床实践中,中医药诊治乳腺癌可能更多从宏观处着眼,并不受限于基因靶目标。

Objective To observe and analyze basic clinical characteristics of triple negative breast cancer（ TNBC） patients.Methods A retrospective cohort study was conducted. Clinical characteristics of triple negative breast cancer were analyzed,and compared with HER-2 over-expression breast cancer as well. Results One hundred and eight TNBC and 53 HER-2 over-expression breast cancer patients were enrolled. These patients showed average age was around 47,most patients received modified radical mastectomy,major pathological type was invasive ductal carcinoma,36. 1% patients showed positive ALN,49. 3%patients showed positive Ki67,and 8（ 7. 4%） patients had post-operation metastasis. Compared with HER-2 over-expression group,TNBC group showed lower age,preferred breast conserving surgery,and higher Ki67 positive rate. The major syndromes of TNBC patients were deficiency of both Qi and Yin,and disharmony between Chong and Ren,and asthenia as phlegm,blood stasis were also observed. The clinical characteristics of Traditional Chinese Medicine（ TCM） were similar between TNBC and HER-2 over-expression breast cancer group. Conclusion The clinical characteristics showed some differeces between TNBC and HER-2 over-expression breast cancer patients,but clinical features of TCM were similar in two groups. This indicates diagnosis and treatment of breast cancer patients may from macroscopic view and not only limited by genic targets in TCM clinical practice setting.