南阳地区妇女三阴乳腺癌临床特征及预后分析

Clinical Features and Prognosis of Female Patients with Triple Negative Breast Cancer in Nanyang Region

目的探讨南阳地区妇女三阴乳腺癌临床特征及预后。方法回顾性分析218例确诊并且行手术切除治疗的南阳地区妇女乳腺癌患者临床资料,按照免疫组织化学检测雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(Her-2)均为阴性者共63例为三阴组,ER、PR、Her-2有一项或多项阳性者共155例为非三阴组,分析2组临床特征及预后。结果三阴组患者平均年龄、未绝经患者、病理分级Ⅲ级、TNM分期T3、腋淋巴结转移阳性、病理类型为浸润性导管癌、肿瘤直径≥5 cm者所占比例明显高于非三阴组(P<0.05)。三阴组患者5年复发率41.27%、转移率34.92%,非三阴组5年复发率22.58%、转移率20.00%;三阴组淋巴结转移率、内脏转移率、骨转移率、脑转移率分别为12.70%、28.57%、15.87%、22.22%,非三阴组为6.45%、14.19%、12.26%、11.61%,2组差异有统计学意义(P<0.05)。三阴组3年、5年无瘤生存率为42.86%、23.81%,总生存率为85.71%、66.67%;非三阴组3年、5年无瘤生存率为63.23%、43.87%,总生存率为94.19%、81.94%。3年、5年无瘤生存率及总生存率三阴组均低于非三阴组(P<0.05)。结论南阳地区妇女三阴乳腺癌具有发病早、组织学分级高、浸润性强的特点,术后更容易发生复发及转移,预后较差。

Objective To explore the clinical features and prognosis of female patients with triple negative breast cancer in Nanyang region. Methods Retrospective analysis of clinical data of 218 female patients with triple negative breast cancer treated with surgical resection in Nanyang region were conducted, according to the immunohistochemical testing,63 cases with estro- gen receptor （ ER）, progesterone receptor （ PR）, epidermal growth factor receptor 2 （ Her-2 ） negative were triple negative group, 155 cases with ER,PR,Her-2 not all negative were non-triple negative group,clinical features and prognosis of the 2 groups were analyzed. Results Average age, non-postmenopausal patients, pathology classification grade HI, TNM stage T3, positive axillary lymph node metastasis and infiltrating ductal carcinoma and tumor diameter I〉 5 cm of triple negative group were significantly higher than non-triple negative group （P 〈 0.05 ） ;in triple negative group, 5-year recurrence rate was 41.27%, transfer rate was 34.92% ,and those of non-triple negative group were 22.58% ,20.00% ;in triple negative group,lymph node metastasis rate,internal transfer rate, bone metastases rate, brain metastasis rate were respectively 12.70% ,28.57% , 15.87% ,22.22% , and those of non-triple negative group were 6.45% ,14.19% ,12.26% ,11.61% ,there had statistical difference （P 〈0.05） ;3-year,5-year disease-free survival rates in triple negative group were 42.86% and 23.81% ,3-year,5-year overall survival rates were 85.71%, 66.67% , and 3-year,5-year disease-free survival rates in non-triple negative group were 63.23 % and 43.87 % ,3-year,5-year o- verall survival rates were 94.19% ,81.94% ,3-year and 5 years disease-free survival and overall survival of triple negative group were significantly lower than non-triple negative group （ P 〈 0. 05 ）. Conclusion Female patients with triple negative breast cancer in Nanyang region are younger at onset, with high histological grade and invasive characteristics, are more likely to occur postoperative recurrence and metastasis, with poor prognosis.