三阴性乳腺癌的治疗进展——吴新红.pptVIP

三阴性乳腺癌的治疗现状 湖北省肿瘤医院乳腺科 吴 新 红 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 2011年St Gallen共识乳腺癌亚型 亚型 定义 Luminal A型 ER和（或）PR阳性，HER2阴性，Ki67低表达（＜14%） Luminal B型 Luminal B（HER2阴性），ER和（或）PR阳性，HER2阴性，Ki67高表达（≥14%） Luminal B（HER2阳性），ER和（或）PR阳性，HER2过表达或增殖，Ki67任何水平 HER-2过表达型 HER2阳性（非Luminal），ER和PR缺失，HER2过表达或增殖 基底样型 三阴性（导管），ER和PR缺失，HER2阴性 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 一、三阴性乳腺癌（TNBC） : 概念 Triple negative andbasal-like Basal but not triple negative 15-40% are ER+, PR+ or HER2+ Triple negative but not basal Clinical assay(IHC) Gene arrays ER- / PgR- / HER2- Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. BRCA1、Basal-Like 、TNBC乳腺癌的关系 Leslie K. et al. Adv. Anat. Pathol. 2007; 14: 419-430 Basal-like Triple Negative BRCA1 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 二、TNBC的风险因素(排除 BRCA 状态) Younger age at menarche Higher parity Younger age at full term pregnancy Shorter duration of breast feeding High body mass index (BMI) High waist to hip ratio Lack of exercise Fulford et al, Histopathology 2006; Livasy et al, Mod Pathol, 2006, Bauer KR Cancer 2007 Carey JAMA 2006 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 三、TNBC预后因素 Large tumor size Presence of nodal metastasis Presence of distant metastasis Presence of central necrosis Absence of androgen receptor Basal phenotype EGFR Age 40 ? (Liedtke et al. ASCO 2010) Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 占所有乳腺癌病理类型的 10.0%~20.8%； 具有特殊的生物学行为和临床病理特征； 预后较其他类型差； 多发生于绝经前年轻女性； 尤其是非洲裔美国妇女： 50岁以下非洲裔美国妇女的发病率甚达39%； 白种人则仅为16%。 四、TNBC－流行病学 Evaluati