124例三阴性乳腺癌临床病理因素与预后分析

Retrospective analysis of clinic-pathological prognostic factors of 124 triple-negative breast cancer patients

目的:三阴性乳腺癌(triple-negative breast cancer,TNBC)预后差,易复发转移,缺乏有效的治疗手段。本文回顾性分析TNBC及基底细胞型的临床病理因素与预后的关系。方法:纳入江苏省肿瘤医院124例TNBC,Fisher法分析临床病理因素之间的相关性,Kaplan-Meier法分析Ki-67/p53与无进展生存期的相关性,COX回归模型分析无进展生存期的预后因素。结果:TNBC肿块大小与腋窝淋巴结转移相关,Ki-67高表达与腋窝淋巴结转移相关,p53阳性与病理分级相关。TNBC及基底细胞型中,Ki-67高增殖与p53阳性患者具有相对较差的无病生存期(P<0.05)。临床分期、腋窝淋巴结转移阳性、Ki-67高增殖与p53阳性是TNBC无病生存的独立预后因素。结论:本文证实Ki-67及p53是TNBC生存预后的预测因子,为TNBC延长生存、改善预后提供依据。

Objective： Triple-negative breast cancer（TNBC） is an aggressive subgroup of breast cancer with poor prognosis,high recurrence and metastasis rate,lack of effective target therapy.This study was to investigate the TNBC and base-like subgroup clinic-pathologic prognostic factors retrospectively. Methods： 124 cases of TNBC patients treated in Tumor Hospital of Jiangsu Province were enrolled in the research.Fisher precise method was used to examine the association between clinical characteristics.Kaplan-Meier method was performed to examine the association between p53/Ki-67 and disease free survival time（DFS） in TNBC and base-like subgroup.Univariate and multivariate analyses of COX model were used to distinguish the independent prognosis factors of DFS（disease free survival）. Results： Base-like subgroup accounted for 48.3 % of TNBC.p53 was positive in 46.8% and the Ki-67 high index was in 55.6% of TNBC.Positive p53 was associated with histological grade and high Ki-67 with lymph node metastasis.Lymphatic metastasis,serious clinical stage,positive p53 and Ki-67 high index significantly associated with high risk of recurrence and poor DFS of TNBC and base-like subgroup. Conclusion： This study indicated that lymphatic metastasis,clinical stage,p53,Ki-67 may be prognostic factors in TNBC.