许建利(三阴性乳腺癌临床病理特征及预后分析).doc

·大会交流· 三阴性乳腺癌临床病理特征及预后分析 许建利 吴诚义400016 重庆，重庆医科大学附属第一医院内分泌外科【摘要】目的 了解三阴性乳腺癌（TNBC）临床病理特征及其预后。方法 收集我科手术切除并经病理证实的465例原发性乳腺癌的临床病理资料，根据ER、PR及Her-2蛋白免疫组化表达分为两类：TNBC和非TNBC，并随访其预后情况，比较两类乳腺癌临床病理特征及预后的差异。结果 TNBC有73例，占15.7%，多见于50岁前未绝经女性，随访369例中复发转移39例，复发转移率（18.3%，11/60）高于非TNBC（9.1%，P=0.033）。结论：TNBC患者发病年龄较早，易发生复发转移，预后较差。 【关键词】乳腺肿瘤；三阴性；临床病理特征；预后 【中图法分类号】R737.9 【文献标识码】B Pathological characteristics and prognosis of triple-negative breast cancerXU Jian-li,WU Cheng-yi. Department of Endocrine Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China Corresponding author: WU Cheng-yi, 400016 Chongqing，the Department of Endocrine Surgery, the First Affiliated Hospital of Chongqing Medical University【Abstract】Objective To explore the pathological characteristics and prognosis of triple-negative breast cancer(TNBC).Methods the pathological data of 465 cases of operable primary breast cancer were analyzed.TNBC was immunohistochemically defined by a lack of expression of ER, PR and Her-2.The differences of pathological characteristics and prognosis between TNBC and non-TNBC were explored.Result TNBC count for about 15%(73/465) of all breast carcinomas.TNBC correlated with younger(50y) and premenopausal women(P0.05). The follow-up time of the 369 cases was truncated at January 2009,and 39 cases had recurrence or metastasis,the relapse rate of TNBC(18.3%,11/60) was higher than that of non-TNBC(9.1%,28/309, P =0.033).Conclusion The patients with TNBC were younger,and had an increased likelihood of relapse. 【Key words】 Breast neoplasms;Triple-negative;Clinicopathological characteristics; Prognosis 三阴性乳腺癌（Triple-negative breast cancer，TNBC）作为乳腺癌中的一个亚型，由于内分泌治疗及针对Her-2过表达的靶向治疗效果欠佳，预后较差，逐渐引起医学界的关注。本文就TNBC临床病理特征及预后作一分析。1 资料与方法 1.1 资料来源 收集2005年1月2006年12月重庆医科大学附属第一医院内分泌外科手术切除并经病理检查证实的465例原发性乳腺癌的临床病理资料，包括发病年龄、月经状态、肿瘤大小、病理类型、组织学分级、腋窝淋巴结转移情况及ER、PR、Her-2、P53免疫组化状态，其中病理类型组织学分级均来自重庆医科大学病理诊断中心的病理报告。 1.2 方法 根据ER、PR及Her-2蛋白免疫组化表达情况将收集到的465例乳腺癌分为两类：TNBC：即E