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三阴性乳腺癌的临床病理特征及预后分析:附108例报告

[Analysis of clinicopathological characteristics and prognosis for triple negative breast cancer: a report of 108 cases].

作者信息

Guan Yin, Xu Bing-He

机构信息

Department of Medical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Science, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2008 Mar;30(3):196-9.

Abstract

OBJECTIVE

To analyze the incidence, clinical and pathological characteristics, survival and prognostic factors of so-called triple negative breast cancer (TNBC) with negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2).

METHODS

Clinical and pathological as well as follow-up data of TNBC patients between Jan. 1999 to Dec. 2002 were collected and analyzed.

RESULTS

Totally, the pathological result of 1175 breast cancer patients were retrospectively reviewed, and 158 patients were found with negative ER, negative PR and HER-2 scored as 0 or 1 + by immunohistochemistry staining. Eventually, only 108 patients with ER-negative, PR-negative and HER-2-negative (score: 0 ) were analyzed. Of the 108 patients, 8 had breast cancer family history, 3 oophoroma family history and one had ever suffered from oophoroma herself. The median age of the 108 TNBC patients was 47.0 years, and 75.0% of them had stage I or II disease. The majority of pathological types were grade II or III invasive ductal carcinomas, and 92.6% of the tumors were staged as T1 or T2. Lymph node metastases were detected in 49. 1% of these patients. Event-free survival, distant metastasis-free survival, local relapse-free survival and overall survival at 5 years were 68.1%, 70.9%, 72.1% and 76.9%, respectively. Though lymph node metastasis and lymph-vascular invasion were all found to be correlated with overall survival, however, only the lymph node metastasis was an independent factor that affected the overall survival revealed by the Cox proportional hazard model analysis.

CONCLUSION

Triple negative breast cancer has distinct clinical and pathologic characteristics. The incidence of triple negative breast cancer in Chinese is similar to that in white but lower than that in black women. Most of the triple negative breast cancer in China is composed of sporadic breast cancer. Lymph node metastasis is an important independent prognostic factor. Clinical outcome of this series is similar to that in white women, while better than that in black women after appropriate radiotherapy and anthracycline-based chemotherapy. Further study is still necessary to explore new treatment in order to improve the prognosis of triple negative breast cancer.

摘要

目的

分析雌激素受体(ER)、孕激素受体(PR)及人表皮生长因子受体2(HER-2)均为阴性的所谓三阴性乳腺癌(TNBC)的发病率、临床及病理特征、生存情况及预后因素。

方法

收集并分析1999年1月至2002年12月期间TNBC患者的临床、病理及随访资料。

结果

共回顾性分析了1175例乳腺癌患者的病理结果,发现158例患者ER阴性、PR阴性且HER-2免疫组化染色评分为0或1+。最终,仅对108例ER阴性、PR阴性且HER-2阴性(评分:0)的患者进行分析。在这108例患者中,8例有乳腺癌家族史,3例有卵巢癌家族史,1例本人曾患卵巢癌。108例TNBC患者的中位年龄为47.0岁,75.0%的患者为Ⅰ期或Ⅱ期疾病。病理类型多为Ⅱ级或Ⅲ级浸润性导管癌,92.6%的肿瘤分期为T1或T2。49.1%的患者检测到淋巴结转移。5年无事件生存率、无远处转移生存率、无局部复发生存率及总生存率分别为68.1%、70.9%、72.1%和76.9%。虽然淋巴结转移和淋巴管浸润均与总生存相关,但Cox比例风险模型分析显示,只有淋巴结转移是影响总生存的独立因素。

结论

三阴性乳腺癌具有独特的临床和病理特征。中国三阴性乳腺癌的发病率与白人相似,但低于黑人女性。中国的三阴性乳腺癌大多由散发性乳腺癌组成。淋巴结转移是重要的独立预后因素。经适当放疗和以蒽环类为基础的化疗后,本系列患者的临床结局与白人女性相似,优于黑人女性。仍需进一步研究探索新的治疗方法以改善三阴性乳腺癌的预后。

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