Analysis of the Clinicopathologic Features and Prognosis in Triple-Negative Breast Cancer

OBJECTIVE To investigate the clinical and pathological features,as well as prognosis in triple-negative breast cancer patients.METHODS A total of 509 cases of operable breast cancer from January,2002 to June,2002 treated in the Cancer Hospital of Tianjin Medical University were analyzed.The Her-2,ER and PR status was determined using immunohistochemistry.Of the total cases,one group was identifi ed as triple negative breast cancer,ie defi ned as ER,PR and Her-2 negative.The other group was non-triple-negative breast cancer.Clinicopathologic features of the groups were compared and 5-year disease-free survival(DFS) analyzed by the Kaplan-Meier method.RESULTS Of the total cases,21.4%(109/509) of cases were found to be triple-negative while 78.6%(400/509) were non-triple-negative.The triple negative group had higher incidence rates than the non-triple-negative group of the medullary type and Grade Ⅲ tumors(P < 0.05).There was no other difference in the clinicopathologic features between the 2 groups.From follow-up to June,2007,21.1%(23/109) of the triple-negative group and 12.7%(51/400) of the non-triple negative group had a local recurrence or distant metastasis,resulting in a signifi cant difference(P < 0.05).In the triple-negative group and non-triple-negative group,5-year DFS were 78.9% and 87.3% respectively.There was a statistically signifi cant difference between the 2 groups(P = 0.031).CONCLUSION Compared with non-triple-negative breast cancer,triple-negative breast cancer patients have an increased likehood of a local recurrence or distant metastasis and a poorer prognosis.

Triple negative breast cancer: 5 years follow-up

Objective： The aim of the study was to investigate the long-term therapeutic effects of triple negative breast cancers （TNBCs） and find a standardized treatment. Methods： The clinical data and survival status of 69 patients with TNBC were collected, who were treated from 2003 to 2007 at Chongqing Cancer Institute, China. Results： Median observation for 61 months showed the local recurrence rate was 13.0% （9/69）, the overall survival （OS） rate was 76.8% （53/69） and the disease free survival （DFS） rate was 59.4% （41169）. Log-rank univariate survival analysis showed the OS and DFS rates of TNBCs with axillary lymph node metastasis were 38.1% and 23.8%, respectively, and the OS and DFS rates of triple negative breast cancer with axillary lymph node non-metastasis were 93.6% and 75.0%, respectively. There were significant differences comparing with two groups. Indictor analysis of age, menstruation status, tumor size, TNM stage, histological type, neoadjuvant chemotherapy and p53 did not show any prognostic influence. Conclusion： The axillary nodes metastasis is associated with DFS and OS in triple negative breast cancers. Cisplatin-based chemotherapy may be good choice for triple negative breast cancers with metastasis or local recurrence, who received Anthracycline and Taxane-based chemotherapy. Targeted therapies strategies such as EGFR-targeted therapy may be necessary.

TAC方案术前辅助化疗对三阴性乳腺癌的疗效观察

目的探讨术前TAC辅助化疗方案治疗三阴性乳腺癌（TNBC）的临床疗效.方法 2005年1月至2008年1月确诊的45例女性TNBC患者术前给予TAC辅助化疗2～3周期后进行手术治疗,分析近远期化疗疗效及手术前后生活质量改变.结果 TNBC控制率91.1%,生活质量显著改善或改善30例（66.7%）、稳定12例（26.7%）、下降3例（6.7%）,主要不良反应中性粒细胞减少24例（53.3%）,中性粒细胞减少性发热21例（46.7%）,恶心呕吐18例（40.0%）,腹泻16例（35.6%）,口腔黏膜炎13例（28.9%）,乏力/虚弱10例（22.2%）;手术后患者生理状况、社会/家庭状况、情感状况和附加的关注等领域显著改善（P〈0.05）,功能状况差异无统计学意义（P〉0.05）;术后出现局部复发9例,远处转移13例（转移部位主要为肺脏、肝脏、骨和脑）,3年生存率82.2%.结论 术前应用TAC辅助化疗方案能提高三阴性乳腺癌治疗效果,改善患者生活质量,提高3年生存率.

乌苯美司联合TAC方案治疗三阴性乳腺癌临床研究

目的观察乌苯美司联合TAC方案治疗三阴性乳腺癌(TNBC)的临床疗效。方法选取医院2015年1月至2017年6月收治的TNBC患者168例,采用随机数字表法分为研究组与对照组,各84例。两组患者均给予TAC方案治疗,研究组患者加服乌苯美司片,两组均以21 d为1个疗程,治疗4个疗程。结果研究组总有效率为94.05%,明显高于对照组的73.81%(P<0.05);治疗后,两组患者各项生活质量评分均明显高于治疗前,且研究组明显高于对照组(P<0.05);治疗后,两组患者的CD3+,CD4+,CD4+/CD8+和自然杀伤(NK)细胞水平均较治疗前明显升高,CD8+水平较治疗前明显降低,且研究组均明显优于对照组(P<0.05);两组毒副作用发生率相当(P>0.05)。结论乌苯美司联合TAC方案治疗TNBC疗效较好,可有效改善患者的临床症状和生活质量,提高免疫功能。

三阴性乳腺癌的临床特点和生存分析

目的回顾分析经免疫组化检测ER-、PR-和HER-2-乳腺癌(三阴性乳腺癌)的临床资料,探讨其临床特点和生存情况。方法回顾分析我院2001年1月～2004年3月诊治的41例三阴性乳腺癌患者的发病年龄、肿瘤大小、淋巴结转移情况、术后辅助治疗、肿瘤复发及生存情况。结果41例三阴性乳腺癌病例中,中位发病年龄49岁,43.6%的患者首诊时伴有淋巴结转移;可随访的35例病例中,27例接受了术后辅助治疗。中位随访时间5年,1、3、5年生存率分别为100.0%、74.0%和57.0%,20例出现了肿瘤复发和转移,内脏转移40.0%,软组织转移20.0%,骨转移6.0%。结论三阴性乳腺癌首诊时淋巴结转移率高,复发后内脏及软组织转移率高,生存时间较短。

三阴性乳腺癌中COX-2表达及其与临床病理特征关系的Meta分析

目的:分析比较COX-2基因在三阴性乳腺癌患者与非三阴性乳腺癌患者中的表达情况,评价COX-2基因是否能够成为三阴性乳腺癌的一个有效标志物。方法:计算机检索PubMed、Medline、Cochrane Collaboration Library、CNKI、万方、VIP数据库,收集国内外1989年至2018年公开发表的所有相关病例对照研究进行Meta分析。结果:共纳入9个病例对照研究,其中三阴性乳腺癌384例,非三阴性乳腺癌1 390例。Meta分析结果显示,COX-2在三阴性乳腺癌患者与非三阴性乳腺癌患者中的表达差异具有统计学意义[OR=1.41,95%CI(1.10,1.81)];COX-2在三阴性乳腺癌中的表达与淋巴结转移及组织大小相关[OR=5.89,95%CI(2.72,12.78);OR=2.39,95%CI(1.01,5.68)],而与患者年龄无关[OR=1.12,95%CI (0.55,2.30)]。结论:我们的研究显示,COX-2的表达与乳腺癌的分子分型有关,且在三阴性乳腺癌中表达更高。在三阴性乳腺癌中,COX-2阳性者更易发生淋巴结转移,且肿瘤组织更大。