Zhang Hui-ming, Xuan Li-xue, Gao Ji-dong, Zhang Bao-ning, Zhao Ping
Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
Zhonghua Wai Ke Za Zhi. 2009 Apr 1;47(7):506-10.
To compare the clinical characteristics of triple-negative (TN) breast cancer and non-triple-negative (NTN) breast cancer, enrich the information of TN patients, and provide evidences for individualized combined treatment.
The data of 408 cases received operation in the year of 2002 was enrolled in this study. TN patients were confirmed according to the immunohistochemical (IHC) test of estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu. The clinical characteristics, recurrence, metastasis and survival were compared between the two groups.
Seventy-seven patients (18.9%) were confirmed TN cases. The median follow-up was 64 months (range, 3-79 months). Of all the cases, 58 occurred local recurrence or metastasis and 51 died, it was 19 and 12 in TN group. Compared with the NTN group, the TN patient tended to be younger and the tumor mass larger (P=0.015 and 0.011). However, axillary lymph nodes metastasis occurred more often in NTN patients than in TN patients (P=0.001). The rate of local recurrence and metastasis in TN group was significantly higher than in NTN group (P=0.005 and 0.025), and TN cases were more likely to develop lung metastasis than NTN patients (P<0.01). The 3-year and 5-year overall survival rate in TN group were significantly lower than in NTN group (86.4% vs. 93.4%, P=0.0205; 77.7% vs. 87.9%, P=0.0215). The 3-year and 5-year disease-free survival rate in TN group were also significantly lower than in NTN group (78.4% vs. 92.4%, P=0.0038; 72.8% vs. 85.8%, P=0.0041). Tumor size, lymph node status and triple-negative were the most important factors influencing the prognosis on multivariate Cox regression analysis.
TN breast cancer haa some specific clinical characteristics. The prognosis of TN patients is worse than that of NTN patients. Further study is needed to find individualized treatment for TN breast cancer patients.
比较三阴性（TN）乳腺癌与非三阴性（NTN）乳腺癌的临床特征，丰富TN患者的信息，并为个体化联合治疗提供依据。
纳入2002年接受手术治疗的408例患者的数据。根据雌激素受体（ER）、孕激素受体（PR）和HER-2/neu的免疫组织化学（IHC）检测确诊TN患者。比较两组患者的临床特征、复发、转移及生存情况。
77例患者（18.9%）确诊为TN病例。中位随访时间为64个月（范围3 - 79个月）。所有病例中，58例发生局部复发或转移，51例死亡，TN组分别为19例和12例。与NTN组相比，TN患者往往更年轻，肿瘤肿块更大（P = 0.015和0.011）。然而，NTN患者腋窝淋巴结转移比TN患者更常见（P = 0.001）。TN组局部复发和转移率显著高于NTN组（P = 0.005和0.025），且TN病例比NTN患者更易发生肺转移（P < 0.01）。TN组3年和5年总生存率显著低于NTN组（86.4%对93.4%，P = 0.0205；77.7%对87.9%）P = 0.0215）。TN组3年和5年无病生存率也显著低于NTN组（78.4%对92.4%，P = 0.0038；72.8%对85.8%）P = 0.0041）。多因素Cox回归分析显示，肿瘤大小、淋巴结状态和三阴性是影响预后的最重要因素。
TN乳腺癌具有一些特定临床特征。TN患者的预后比NTN患者差。需要进一步研究以找到TN乳腺癌患者的个体化治疗方法。
