摘要
目的探讨乳腺癌患者三阴性与人表皮生长因子受体2(HER-2)过表达的临床病理特征及预后。方法采用免疫组织化学染色法检测568例乳腺癌组织中激素受体(ER)、孕激素受体(PR)、HER-2的表达。根据乳腺癌分子表型不同进行分型,三阴性(ER、PR、HER-2均为阴性),HER-2过表达型(ER与PR阴性,HER-2阳性),对两组患者的临床病理资料进行分析。采用电话或门诊随访患者至2013年12月年或患者死亡,比较两组患者2年及5年无病生存率与总生存率、无病生存时间、复发或转移情况,采用Kaplan-Meier法进行生存分析,log-rank检验进行生存率比较。结果 568例患者中,三阴性与HER-2过表达型分别为85例(14.96%)、12例(21.13%)。三阴性组恶性肿瘤家族史患者比率、组织学分级3级患者比率和浸润性导管癌患者比率均显著高于HER-2过表达组,差异具有显著性(P<0.05)。患者最长随访时间为120个月,最短为10个月,平均(85.89±38.59)个月。三阴性组乳腺癌复发或转移率显著高于HER-2过表达者(P<0.05),而且脑转移发生率较高,而HER-2过表达组则以骨转移为主。三阴性乳腺癌无病生存时间明显短于为HER-2过表达组(47.99±24.59 vs.75.62±59.5)个月,两组差异有统计学意义(P<0.05)。三阴性组2年及5年无病生存率及总生存率均低于HER-2过表达组,但两组差异不显著(P>0.05)。结论三阴性与HER-2过表达乳腺癌相比,恶性肿瘤家族史比率及肿瘤恶性度高,更易发生脑转移,预后相对较差。
Objective To investigate the clinical and pathological features and prognosis of triple - negative breast cancer（TNBC）and human epidermal growth factor receptor 2（HER - 2）overexpressing breast cancer. Methods Estrogen receptor（ ER）,progesterone receptors （ PR）and HER - 2 expressions were detected in breast cancer samples collected from 568 cases of breast cancer by immunohistochemical staining. According to the phenotype of breast cancer,the patients were divided into TNBC（ER - ,PR - ,HER - 2 - ）group,and HER - 2 overexpression （ER - ,PR - ,HER - 2 ＋ ）group. The clinical and pathological data were analyzed. The patients were followed - up,and 2 and 5 year disease -free survival rate and overall survival rate,disease - free survival time,recurrence and metastasis were compared between two groups. The Kaplan- Meier method and log - rank test were used for survival analysis and survival rate comparison respectively. Results Of 568 patients,triple -negative and HER - 2 overexpression were 85（14. 96% ）,and 120（21. 13% ）,respectively. The percentages of patients with family history of cancer,histological grade 3,and invasive ductal carcinoma in TNBC group were higher than HER - 2 overexpression group（all P 〈 0. 05）. The patients were followed - up for 10 to 120 months（mean 85. 89 ± 38. 59 months）. The recurrence rate and metastasis rate were significantly higher in TNBC group than HER - 2 overexpression group（ P 〈 0. 05）;and the incidence of brain metastases was higher in TNBC group,while bone metastases was higher in HER - 2 overexpression group. The disease - free survival time in TNBC group was significantly shorter than HER - 2 overexpression group（47. 99 ± 24. 59 vs 75. 62 ± 59. 5 months）（ P 〈 0. 05）. Compared with HER - 2 overexpression group,2 - and 5 - year disease - free survival rate and overall survival rates were lower in TNBC group;but the differences were not significant（ P ﹥ 0. 05）. Conclusion Compared to HER - 2 overexpressing breast cancer,more TNBC patients have family history of cancer. TNBC is highly malignant with a higher incidence of brain metastases and relatively poor prognosis.
出处
《临床和实验医学杂志》
2014年第9期699-702,共4页
Journal of Clinical and Experimental Medicine
关键词
乳腺癌
三阴性
HER
-
2
过表达
生存率
Breast cancer
Triple negative
HER - 2 overexpression
Survival rate
