摘要
目的 探讨转移性三阴性乳腺癌（TNBC）的临床、病理特征以及治疗方法和无瘤生存率的相关性. 方法 2007年1月至2012年1月我院共收治转移性TNBC 136例患者,患者均接受手术治疗以及放化疗,对比分析患者不同临床、病理特征及治疗方法与术后3、5年生存率差异,同时观察患者的转移与生存情况.结果 临床Ⅲ期患者3、5年生存率分别为45.9%（17/37）、37.8%（14/37）,较Ⅱ期 [89.9%（89/99）、73.7%（73/99）]患者明显降低（χ2值分别为18.459、12.681,P均〈0.01）.病理分级Ⅲ级患者3、5年生存率分别64.9%（37/57）、43.9%（25/57）,较Ⅰ级[91.7%（22/24）、83.3%（20/24）]及Ⅱ级 [85.5%（47/55）、76.4%（42/55）]明显降低（χ2值分别为14.728、12.450,P均〈0.05）.接受放疗患者3年生存率81.8%（27/33）,较未给予放疗患者59.1%（13/22）明显升高（χ2=5.468,P〈0.05）.肺、肝、脑、骨及锁骨上淋巴结是主要远处转移部位,转移患者生存时间均〈2年. 结论 转移性TNBC是治疗难度较大的一类特殊乳腺癌,保乳手术具有一定价值,放疗只能提高患者的3年生存率,预后影响因素主要有病理分级和临床分期.
Objective To study the clinical,pathological features and therapeutic method of metastatic triple negative breast cancer （TNBC） and its relationship with disease-free survival.Methods One hundred and thirty-six cases of metastatic TNBC patients who were treated from January 2007 to January 2012 in the Third People＇＇s Hospital of Dalian were selected as research objects.All patients received operation and radiochemotherapy,the clinical,pathological features,therapeutic method,the survival rate within 3,5 years,and the metastasis and survival situation of the patients were analyzed.Results For the patients in clinical stage Ⅲ period,the survival rate within 3,5 years were 45.9%（17/37）,37.8%（14/37）,respectively,significantly lower than those in stageⅡperiod （89.9%（89/99）,73.7%（73/99））,and the differences were statistically significant （χ2=18.459,12.681,P〈0.01）.The 3-year survival rate of the patients in pathological grade Ⅲ was 64.9%（37/57）,5-year survival rate was 43.9%（25/57）,significantly lower than those of gradeⅠ（91.7%（22/24）,83.3%（20/24）） and grade Ⅱ（85.5%（47/55）,76.4%（42/55））,the differences were statistically significant （χ2=14.728,12.450,P〈0.05）.The 3-year survival rate of radiotherapy group was 81.8%（27/33）,significantly higher than that of the non-radiotherapy group （59.1%（13/22））,the difference was statistically significant （χ2=5.468,P〈0.05）.Lung,liver,brain,bone and supraclavicular lymph nodes were main distant metastasis,the survival time of patients with metastasis was less than 2 years.Conclusion Metastatic TNBC is a special type of breast cancer that is difficult to treat.Breast conserving surgery has certain application value,radiotherapy can only increase the 3 year survival rate.Pathological grade and clinical staging are the main prognostic factors.
出处
《中国综合临床》
2017年第7期648-651,共4页
Clinical Medicine of China
关键词
转移性三阴性乳腺癌
生存率
临床特征
病理特征
生存质量
Metastatic triple negative breast cancer
Survival rate
Clinical feature
Pathological feature
Quality of life
