Analysis of Clinicopathological Characteristics and Prognosis for Triple Negative Breast Cancer： Report of 178 Cases
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摘要: 目的 探讨三阴性乳腺癌(TNBC)患者的临床病理特点、生存情况和预后影响因素。方法收集雌激素受体(ER)、孕激素受体(PR)和人表皮生长因子受体2(HER2)均阴性的178例乳腺癌患者的临床病理资料，观察其长期生存状况。分析其临床特点及影响预后的因素。结果有乳腺癌家族史的患者4例。主要病理类型为浸润性导管癌(155/178，87.1%）。组织学分级多为Ⅲ级(53.1%）。中位肿瘤最大径2.8 cm(0.2～12 cm），T1、T2期患者160例占89.9%。108例(61.7%）患者无淋巴结转移。分期为Ⅰ、Ⅱ、Ⅲ期的患者分别有60例(33.7％)、81例(45.5％)、31例(17.4％)。58例(48.3 ％)患者p53阳性。中位随访时间74月(10～156月），5年无病生存(DFS)和总生存(OS)率分别是76.9%和86.1%。单因素分析显示T分期、临床分期及淋巴结转移对DFS和OS 均有显著影响。多因素分析显示，淋巴结转移是DFS及OS的独立影响因素。而术后分期是OS的影响因素。共有41例患者出现复发转移及第二原发肿瘤，常见转移部位依次为骨转移、局部复发或同侧锁骨上淋巴结转移、肺或胸膜转移、肝转移及脑转移。结论 本组TNBC肿瘤直径较小，组织学分级低分化比例较高(53.1%）。复发转移以骨转移、局部复发及肺转移为主。淋巴结转移及术后分期是总生存的独立危险因素。Abstract: Objective To investigate the clinicopathological characteristics，survival and prognostic factors of patients with triple negative breast cancer(TNBC). Methods One hundred and seventy-eight patients who were diagnosed as breast cancer with negative estrogen receptor (ER)，progesterone receptor (PR)，and human epidermal growth factor receptor-2 (HER2) at Peking university third hospital were enrolled to collect clinicopathological factors and survival status.Clinical characteristics and prognostic factors were analyzed. Results Four patients had breast cancer family history. One hundred and fifty-five patients (87.1%) had invasive ductal carcinomas，which was the majority of pathological types.53.1% TNBC patients were grade Ⅲ，and 160 (89.9%) of the tumors were staged T1 or T2.The median clinical tumor size was2.8 cm(0.2～12 cm）.One hundred and eight patients(61.7%）had no lymph node metastasis.According to TNM staging system，60 patients (33.7%) were stage Ⅰ，81 patients (45.5％) were stage Ⅱ，and 31 patients (17.4%) were stage Ⅲ.58 patients (48.3％) had positive p53.With median follow up time of 74.0 months (range 10～156 months)，the 5-year cumulative disease free survival (DFS) of all patients was 76.9%.5-year cumulative overall survival (OS) was 86.1%.T stage，TNM stage and lymph node metastasis status were all correlated with DFS and OS in the univariate analysis.In the multivariate analysis，the lymph node metastasis status was found to be an independent prognostic factor for both DFS and OS，and clinical stage was an independent prognostic factor for OS.In total，41 patients were recorded with tumor relapse or metastasis or a second primary tumor.The common metastasis sites were bones，local recurrence or ipsilateral supraclavicular node，lung or pleural，liver and brain. Conclusion In these TNBC patients，the tumors were small，and more than half were low-histology stage.The main recurrence or metastasis sites were bones，local region and lung.Lymph node metastasis and TNM stage were both independent prognostic factors for OS.
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Key words:
- Triple negative breast cancer /
- Pathological characteristics /
- Prognosis
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