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三阴性乳腺癌生存分析及预后影响因素
作者:余韬  李岩 
单位:南京医科大学生物信息学系  江苏 南京 210029 
关键词:乳腺肿瘤 基因 肿瘤抑制 淋巴转移 存活率分析 预后 
DOI:R737.9
出版年,卷(期):页码:2017,32(1):61-65
摘要:

目的 探讨三阴性乳腺癌(triple-negative breast cancer,TNBC)的临床特点和预后情况。方法 收集癌症和肿瘤基因图谱(The Cancer Genome Atlas,TCGA)数据库700例乳腺癌患者资料。根据分子标志物和激素受体状态,将其分为多种亚型。对三阴性和非三阴性乳腺癌临床数据进行Kaplan-Meier生存分析及χ2检验,预后影响因素采用单因素和多因素分析。结果 生存曲线显示,TNBC患者(n=85)与非三阴性乳腺癌(non triple-negative breast cancer,nonTNBC)患者(n=615)的10年总生存率(overall survival,OS)比较差异具有统计学意义(P=0.005),并低于luminal A型乳腺癌患者(P=0.001),与其他亚型患者比较差异均无统计学意义(均P>0.05)。TNBC与nonTNBC患者在绝经状态、组织类型、AJCC肿瘤病理状态、AJCC淋巴结病理状态和年龄方面比较差异均具有统计学意义(均P<0.05)。综合单因素及多因素分析发现,淋巴结转移是TNBC重要的独立预后因素(P=0.021)。伴随肿瘤患者生存时间也短于无肿瘤患者(P=0.009)。结论 TNBC临床病理特征与其他类型的乳腺癌差异较大。手术完全清除肿瘤对TNBC患者意义重大。

Objective To analyze the clinical features and prognosis of triple-negative breast cancer (TNBC).Methods A total of 700 breast cancer patients from the Cancer Genome Atlas (TCGA) were analyzed retrospectively. Based on molecular markers and the status of hormone receptors, breast cancer were categorized. The clinical data of TNBC and non-TNBC patients were analyzed by Kaplan-Meier survival analysis and χ2 test. The prognosis factors were examined by univariate and multi-variates models.Results Eighty-five TNBC patients were enrolled in this study. Survival analysis demonstrated that the overall survival rates of TNBC patients in 10 years were significantly different with that of non-TNBC patients (P=0.005), and was lower than that of luminal A breast cancer patients (P=0.001), but was not significantly different with other types of breast cancer (P>0.05). Significant differences were also shown in menopause status, histological type, AJCC tumor pathologic status, AJCC nodes pathologic status and age between TNBC and non-TNBC patients (P<0.05). Moreover, combining the Results of both univariate and multivariate analyses, the number of metastatic lymph nodes was an important independent prognostic factor of TNBC (P=0.021). The survival time of patients with tumor was significantly shorter than that of patients without tumor (P=0.009).Conclusions The clinico-pathological features of TNBC were significantly different with other types of breast cancer. Complete removal of tumor by surgery is of great importance to TNBC patients.

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