三阴性乳腺癌的临床病理特点及预后分析研究

摘要

Objective :To analyze the clinicopathological features, survival rate, and prognostic factors in triple negative breast cancer patients. Methods:The data of 30 triple - negative breast cancer patients were retrospectively analyzed. Clinicopathological characteristics, marker of immunohistochemistry and survival rate were surveyed. Results: Of all breast cancer patients registered in these two hospital during this period, these 30 triple - negative breast cancer accounted for 5.7％ with a median age of 50 years( 39 - 76years ). The pathological types were infitrating ductal carcinoma( 70.0％ ), simple carcinoma( 13.3％ ), myecarcinoma( 6.7％ ), tubular adenocarcinoma( 6.7％ ), intraductal carcinoma( 3.3％ ). The stages included stage - Ⅰ 16.7％ ,stage - Ⅱ 50.0％ ,stage - Ⅲ 26.7％ and stage - Ⅳ 6.7％. The patients with vascular invasion accounted for 33.3％ ,and with nerve invasion 16.7％. The median survival time was 3.8 years( 1.6 - 7.5 years ). The factors which were found to compromise overall survival were tumor size ,lymph node status, clinical stage, vascular invasion and nerve invasion in the univariate analysis. Tumor size and lymph node status were found to be independent prognostic factors for overall survival in the multivariate analysis. The 3 -years overall survival rate was 65.7％. Conclusion:Patients with triple -negative breast cancer had low incidence rates , high histological grade and high rate of local and systemic relapse . The major pathological type was infitrating ductal carcinoma. The factors which were found to compromise overall survival were tumor size, lymph node status, clinical stage, vascular invasion and nerve invasion in the univariate analysis. Tumor size and lymph node status were found to be independent prognostic factors for overall survival in the multivariate analysis.%目的:探讨三阴性乳腺癌患者临床病理特点、生存率以及影响预后的因素.方法:回顾性分析30例三阴性乳腺癌患者的资料,分析其临床病理特点、免疫组化指标和各种治疗方式对生存率的影响.结果:全组30例患者均为女性,占同期收治乳腺癌患者的5.7%,中位年龄50岁(39-76岁).其中,浸润性导管癌21例(70.0%),单纯癌4例(13.3%),髓样癌2例(6.7%),管状腺癌2例(6.7%),导管内癌1例(3.3%).Ⅰ期患者5例(16.7%),Ⅱ期15例(50.0% ),Ⅲ期8例(26.7%),Ⅳ期2例( 6.7%).核分级1级4例(13.3%),2级11例(36.7%),3级15例(50.0%).伴有脉管瘤栓10例(33.3% ),伴有神经浸润5例( 16.7%).中位生存时间3.8年(1.6-7.5年).单因素分析结果显示,影响总生存的因素为肿瘤大小、淋巴结状态、临床分期、脉管瘤栓和神经浸润.多因素分析结果显示,肿瘤大小和淋巴结状态是影响预后的独立因素.3年总生存率65.7%.结论:三阴性乳腺癌发病率较低,组织学分级较高,多为浸润性导管癌,易较早出现复发和转移.影响生存率的因素为肿瘤大小、淋巴结状态、临床分期、脉管瘤栓和神经浸润,其中影响预后的独立因素是肿瘤大小和淋巴结状态.