上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (5): 637-.doi: 10.3969/j.issn.1674-8115.2011.05.023

• 论著（临床研究） • 上一篇    下一篇

三阴性乳腺癌的临床病理特征和预后影响因素分析

须捷平, 徐曙光, 张 云, 俞 羚, 吴连明, 殷志强, 曹 晖   

  1. 上海交通大学 医学院附属仁济医院普外科, 上海 200127
  • 出版日期:2011-05-28 发布日期:2011-05-27
  • 通讯作者: 徐曙光, 电子信箱: xshg@hotmail.com。
  • 作者简介:须捷平（1977—）, 男, 主治医师, 硕士；电子信箱: xujieping@hotmail.com。

Clinicopathological features and prognostic factors of triple-negative breast cancer

XU Jie-ping, XU Shu-guang, ZHANG Yun, YU Ling, WU Lian-ming, YIN Zhi-qiang, CAO Hui   

  1. Department of General Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2011-05-28 Published:2011-05-27

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摘要：

目的 探讨三阴性乳腺癌（TNBC）的临床病理特征和预后影响因素。方法 收集547例女性乳腺癌患者的病历及随访资料，患者分为TNBC组和非三阴性乳腺癌（non-TNBC)组，分析TNBC的临床病理特征和预后影响因素。结果 TNBC组和non-TNBC组的患者数分别为71（13.0%）和476（87.0%）。TNBC组与non-TNBC组患者年龄<35岁（14.1% vs 1.1%）、有乳腺癌家族史（29.6% vs 9.2%）、肿瘤直径>50 mm（22.5% vs 8.0%）、肿瘤分期Ⅲ期（23.9% vs 16.4%）、肿瘤分级Ⅲ级(40.8% vs 28.8%）、有转移或复发（28.2% vs 10.9%）等指标的差异均具有统计学意义（P<0.01或P<0.05），绝经状态、转移淋巴结数、病理类型、手术方式等指标差异均无统计学意义（P>0.05）。Kaplan-Meier生存分析显示，TNBC组患者5年无病生存率（DFS）和5年总生存率（OS）均显著低于non-TNBC组患者（65.8% vs 85.3%，P<0.01；77.7% vs 88.7%，P<0.05）。Cox比例风险回归模型分析显示，乳腺癌家族史、肿瘤分级和转移淋巴结数是影响TNBC组患者DFS的独立预后危险因素。结论 与non-TNBC患者相比，TNBC患者发病年龄轻、有明显乳腺癌家族史、肿瘤体积大、肿瘤分期晚、肿瘤分级高、易复发转移、DFS和OS低、预后差。

关键词: 乳腺肿瘤, 三阴性, 雌激素受体, 孕激素受体, 人表皮生长因子受体2, 临床特征, 预后

Abstract:

Objective To investigate the clinicopathological features and prognostic factors of triple-negative breast cancer (TNBC). Methods A total of 547 females with breast cancer were selected, and were divided into TNBC group and non-TNBC group. The clinicopathological features and prognostic factors of TNBC were analysed. Results The numbers of patients in TNBC group and non-TNBC group were 71 (13.0%) and 476 (87.0%), respectively. There were significant differences in the parameters of age low than 35 years （14.1% vs 1.1%）, family history of breast cancer (29.6% vs 9.2%), diameter of tumor longer than 50 mm （22.5% vs 8.0%）, tumor stage Ⅲ (23.9% vs 16.4%), tumor grade Ⅲ (40.8% vs 28.8%）and recurrence or metastasis (28.2% vs 10.9%) between TNBC group and non-TNBC group (P<0.01 or P<0.05), while there was no significant difference in the parameters of menopausal status, number of lymph node metastasis, pathological types and surgical approach between these two groups (P>0.05). Kaplan-Meier survival analysis indicated that both 5-year disease-free survival (DFS) and 5-year overall survival (OS) in TNBC group were significantly lower than those in non-TNBC group (65.8% vs 85.3%，P<0.01；77.7% vs 88.7%，P<0.05). Cox proportional hazard regression model analysis revealed that family history of breast cancer, tumor stage and number of lymph node metastasis were independent prognostic risk factors for DFS of TNBC. Conclusion Compared with patients with non-TNBC, patients with TNBC are younger, more often have family history of breast cancer, have larger tumor size, more advanced tumor stage and higher tumor grade, are more prone to recurrence and metastasis, and have lower DFS, lower OS and poorer prognosis.

Key words: breast neoplasm, triple-negative, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, clinical characteristics, prognosis