目的研究三阴性乳腺癌的临床病理特征和预后。方法回顾性分析南京医科大学第一附属医院2003年1月至2009年12月收治的1042例原发乳腺癌患者的临床资料。所有患者通过免疫组化分为3组:ERBB2+,HR+/ERBB-和三阴性乳腺癌。结果183例为三阴性乳腺癌。三阴性乳腺癌患者其肿块直径超过2cm的比例和组织学分级三级发生率比ERBB2+和HR+/ERBB2-患者高(P〈0.01)。而ERBB2+患者的P53阳性率比三阴性乳腺癌患者和HR+/ERBB2-患者高(P〈0.01)。HR+/ERBB2-患者与ERBB2+患者、三阴性乳腺癌患者相比骨转移比例更高(P=0.006)。3组患者间内脏远处转移差异无统计学意义。随访期间,3组5年无复发生存率差异有统计学意义(P=0.029),ERBB2+患者最低,为80.3%。结论本组三阴性乳腺癌患者肿块直径超过2cm比例较高,组织学分级三级发生率较高,但其5年无复发生存率高于ERBB2+患者。
Objective To investigate the clinicopathologic characteristics and prognosis of triple negative breast cancer patients. Methods A retrospective analysis was performed for 1042 primary breast cancer patients admitted in the First Affiliated Hospital of Nanjing Medical University from January 2003 to December 2009. All breast cancer patients were categorized into three subgroups by immunohistochemistry : ERBB2 +, HR +/ERBB2 - and triple negative. Results Of 1042 breast cancer patients recruited, 183 patients were in triple negative group. The rate of larger tumors ( greater than 2 cm in diameter) and grade HI in triple negative patients was higher than that in ERBB2 + and HR +/ERBB2 - patients (P 〈 0.01 ). The positive rate of p53 status in ERBB2 + patients was higher than that in triple negative and HR +/ ERBB2 - patients (P 〈 0. 01 ). No significant differences were observed in other clinical variables. In survival analysis, more bone metastases were observed in HR +/ERBB2 - patients than in ERBB2 + and triple negative patients ( P = 0. 006). However, no significant difference was observed in visceral metastases among the subgroups. There were significantly different recurrence-free survivals (RFS) among the three subgroups throughout the follow-up period (P = 0. 029), the 5-year RFS of ERBB2 + was 80. 3%, which was the worst in three groups. Conclusions Triple negative patients had higher rate of larger tumors (greater than 2 cm in diameter) and grade HI than that in ERBB2 + and HR +/ERBB2 - patients,while its 5-year RFS was higher than ERBB2 + patients.