Lester and Sue Smith Breast Center at Baylor College of Medicine, Houston, TX, USA.
Breast Cancer Res Treat. 2012 Dec;136(3):795-804. doi: 10.1007/s10549-012-2315-y. Epub 2012 Nov 4.
Studies on well characterized, large populations of estrogen receptor (ER)/progesterone receptor (PgR)/HER2-negative [triple-negative (TN)] breast cancer (BC) patients with long-term follow-up are lacking. In this study, we analyze clinical outcomes of TN BC and implications of epidermal growth factor receptor (EGFR) expression. Clinical and biologic features, time to first recurrence (TTFR), and overall survival (OS) were compared in 253 TN versus 1,036 ER positive, PgR positive, HER2-negative [estrogen-driven (ED)] BC. Compared to ED, TN tumors were larger (p = 0.02), more proliferative (high S-phase 54 vs. 17 %, p < 0.0001), more aneuploid (64 vs. 43 %, p < 0.0001) and more likely EGFR positive (≥10 fmol/mg by radioligand-binding assay, 49 vs. 7 %, p < 0.0001). Among TN, EGFR-positive BC were larger (p = 0.0018), more proliferative (p < 0.0001), and more aneuploid, (p < 0.0001) than EGFR-negative BC. Adjuvant-treated TN patients had shorter TTFR (p = 0.0003), and OS (p = 0.0017), than ED patients. However, in untreated patients, no differences in TTFR and OS were observed at 8 years median follow-up. Among TN patients, EGFR expression was not associated with worse outcome. TN tumors have a worse outcome in systemically treated patients but not in untreated patients. EGFR expression, does not predict for worse long-term survival.
缺乏对具有长期随访的特征明确、大样本雌激素受体 (ER)/孕激素受体 (PgR)/人表皮生长因子受体 2 阴性（三阴性，TN）乳腺癌 (BC) 患者的研究。本研究分析了 TNBC 的临床结果和表皮生长因子受体 (EGFR) 表达的意义。比较了 253 例 TN 与 1036 例 ER 阳性、PgR 阳性、HER2 阴性[雌激素驱动 (ED)]BC 患者的临床和生物学特征、首次复发时间 (TTFR) 和总生存 (OS)。与 ED 相比，TN 肿瘤更大（p=0.02），增殖性更强（高 S 期 54%比 17%，p<0.0001），非整倍体性更高（64%比 43%，p<0.0001），且 EGFR 阳性（放射性配体结合分析≥10fmol/mg，49%比 7%，p<0.0001）的可能性更大。在 TN 中，EGFR 阳性 BC 肿瘤更大（p=0.0018），增殖性更强（p<0.0001），非整倍体性更高（p<0.0001），EGFR 阴性 BC。接受辅助治疗的 TN 患者 TTFR（p=0.0003）和 OS（p=0.0017）较短，与 ED 患者相比。然而，在未经治疗的患者中，8 年中位随访时，TTFR 和 OS 无差异。在 TN 患者中，EGFR 表达与较差的预后无关。在接受系统治疗的患者中，TN 肿瘤的预后较差，但在未接受治疗的患者中则不然。EGFR 表达不能预测长期生存较差。
