摘要
目的探讨三阴性乳腺癌(triple negative breast cancer TNBC)患者临床、病理和预后的特点。方法回顾性研究2005年3月一2009年9月期间就诊于新疆医科大学附属肿瘤医院,有完整临床病理资料的319例可手术I^ID期TNBC和Luminal型乳腺癌患者的病历资料,搜集患者的一般资料、月经及生育状况、病理资料、治疗情况并进行随访,分析TNBC的临床病理和预后特征。计数资料的比较采用卡方检验,生存分析使用Log-rank检验。结果319例乳腺癌患者共随访9〜86个月,中位随访时间72个月。其中TNBC共103例,Luminal型乳腺癌共216例。与Luminal型乳腺癌相对比,TNBC病理结果为单一成分比混合成分更常见(P=0.025),其中髓样癌更多为TNBC(P=0.000)o TNBC中原发肿瘤大于T1的患者多于T1患者(P=0.036),腋窝淋巴结转移数目差异无统计学意义(P>0.05)。TNBC中Ki-67表达无统计学差异(P>0.05),但nm23表达为阴性者较多(P=0.006)。TNBC和Luminal型乳腺癌3年总生存率(overall survival OS)分别是91.1%和96.7%,5年OS分别为86.9%和93.8%,差异无统计学意义(P=0.066)o TNEC和Luminal型乳腺癌3年无病生存率disease free survival DFS)分别是79.9%和92.5%,5年DFS分别为76.0%和87.0%,差异有统计学意义(P=0.013)。影响TNBC无病生存率的独立预后因素包括族别、nm23的表达情况和病期(P V0.05)。结洽TNBC具有病理成分单一,肿瘤体积大,nm23表达缺失,无病生存率较低,在维吾尔族中更易复发和转移的特点。
Objective To discuss the clinic-pathological features and prognosis of triple negative breast cancer patients.Methods A retrospective analysis of the medical records of TNBC and Luminal-type breast cancer patients with demographic data, menstruate status, clinical and pathological parameters andtreatment information were undertaken. These patients were randomly chosen from the affiliated tumorhospital of Xinjiang Medical University and treated during March 2005 to September 2009・ Chi-square testswere performed to compare characteristics, and a log-rank test was used for survival. Results Thepatients were followed up for 9 to 86 months, median follow-up time was 72 months, among which 103were TNBC and 216 were Luminal-type breast cancer patients・ Compared to Luminal-type breast cancer,the pathological components of TNBC were more likely to be single (P =0.025)and there was a more portionof medullary carcinoma in TNBC (P V0.001). The tumor was more likely to be larger than T2 in TNBC(P =0.036). There was no statistical difference between Luminal-type and TNBC in axillary lymphnodes metastasis (P >0.05). Expression of Ki-67 between two groups was not statistically different (P >0.05). Expression of nm23 in TNBC was significantly higher than that of Luminal-type breast cancer (P =0.006). 3-year's overall survival (OS) of TNBC and Luminal-type breast cancer were 91.1 % and 96.7% ,and 5-year's OS were 86.9% and 93.8% respectively. 3-year's disease free survival (DFS) of TNBC andLuminal-type breast cancer were 79.9% and 92.5%, 5-yearzs DFS were 76.0% and 87.0% respectively.The independent prognostic factors that affect DFS in TNBC include different minorities , expression ofnm23 and pathological stage (P V0.05)・ Conclusion Characters of TNBC patients in Xinjiang region includeas follows: larger primary tumor, exclusive pathological components, low expression of nm23,lower DFS and higher recurrence and metastatic rates.
作者
单美慧
李鸿涛
罗琳
姚雪梅
马斌林
马静
SHAN Meihui;LI Hongtao;LUO Lin;YAO Xuemei;MA Binlin;MA Jing(Department of Breast and Neck,Affiliated Tumor Hospital,Xinjiang Medical University,Urumqi 830011,China;Department of Epidemiology and Health Statistics,Public Health College of Xinjiang Medical University,Urumqi 830011,China)
出处
《新疆医科大学学报》
CAS
2020年第1期63-68,73,共7页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金面上项目(2019D01C252)
关键词
TNBC
临床病理特征
预后
triple negative breast cancer
clinicopathologic features
prognosis
