40岁以下女性三阴性乳腺癌临床病理特征与预后分析

Clinicopathological features and prognosis of women(≤40 years)with triple negative breast cancer

目的分析40岁以下年轻三阴性乳腺癌(TNBC)患者的临床病理特点、以及影响预后的危险因素。方法回顾性分析来自2009年4月至2012年4月山西省肿瘤医院收治的年龄≤40岁的年轻TNBC患者51例,收集患者的临床病理资料以及生存情况,使用Kaplan-Meier法计算无病生存率(DFS)及总生存率(OS),Cox比例风险模型评估分析影响OS预后的独立危险因素。结果全组51例年轻TNBC患者,占同期收治TNBC患者(242例)的21%。腋窝淋巴结分期为N0、N1、N2、N3的患者分别为21例(41%)、18例(35%)、7例(14%)、5例(10%);术后病理原发肿瘤局部淋巴结远处转移分期(TNM)为Ⅰ、Ⅱ、Ⅲ期患者分别为9例(18%)、27例(53%)、15例(29%)。51例患者的1、3、5年无病生存率(DFS)分别为82%、69%、68%,1、3、5年总生存率(OS)分别为95%、74%、71%。单因素预后分析结果显示,腋窝淋巴结状态、术后病理TNM分期对年轻TNBC患者的5年OS具有显著影响(均P<0.05)。Cox多因素预后分析结果显示,腋窝淋巴结状态是影响年轻TNBC患者预后的独立因素(P<0.01)。结论年轻TNBC患者具有独特的临床病理特征和预后,需要继续探索与预后相关的危险因素。

Objective To analyze the clinicopathological features and the prognosis factors of young women(≤40 years).Methods We retrospectively analyzed the clinical data from 51 young female patients(≤40 years)with triple negative breast cancer(TNBC)in Shanxi Cancer Hospital from April 2009 to April 2012.The disease-free survival(DFS)and overall survival(OS)were calculated by Kaplan-Meier method,and the Cox proportional hazard model was used for multivariate analysis.Results Among 242 TNBC patients,51 patients(21%)were young TNBC.The axillary node stage included:21 patients in N0(41%),18 patients in N1(35%),7 patients in N2(14%)and 5 patients in N3(10%);The postoperative pathological TNM stage included:9 patients in stage Ⅰ(18%),27 patients in stage Ⅱ(53%),15 patients in stage Ⅲ(29%).The 1 year,3 year,5 year DFS was 82%,69%,68%,respectively.The 1 year,3 year,5 year OS was 95%,74%,71%respectively.The univariate analysis showed that N stage,the postoperative pathological TNM stage were correlated with the 5-year OS.However,only the axillary node stage was showed to be an independent prognostic factor assessed by multivariate analysis.Conclusion Young patients with TNBC represent distinctive clinicopathological and prognostic characteristics.Further studies are needed to analyze the prognostic factor with the prognosis.