CAJ | 학술논문

目的探讨三阴性乳腺癌与HER-2过表达乳腺癌患者的l临床病理特征及预后.方法回顾1997年1月至2007年1月行手术治疗的725例原发性乳腺癌的临床资料,根据免疫组化染色结果确定三阴性和HER-2过表达乳腺癌表型,并对2组的临床病理学资料进行比较和生存分析.结果三阴性和HER-2过表达乳腺癌分别占12.29%及24.96%;三阴性乳腺癌有恶性肿瘤家族史者占18.4%,明显高于HER-2过表达组的5.5%(P=0.001);组织学分级3级者占54.0%,也高于HER-2过表达组42.0%(P=0.01);三阴性乳腺癌(74.7%)较HER-2过表达乳腺癌(64.6%)更易发生淋巴结转移(P=0.045);在2年内复发、转移及脑转移(分别为25.3%及8.0%)明显高于HER-2过表达乳腺癌(分别为8.8%和2.2%)(P<0.05),其5年无病生存率(55.6%)明显低于HER-2过表达乳腺癌(69.8%)(P=0.041).2组在年龄、月经状态、肿瘤大小、病理分期、手术方式、病理类型、辅助放化疗、肝肺骨转移比例和总生存率之间差异均无统计学意义(P>0.05).结论与HER-2过表达乳腺癌相比,三阴性乳腺癌更多有恶性肿瘤家族史,肿瘤恶性度更高,更易发生淋巴结和脑转移,无病生存期更短,预后差.
목적 탐토삼음성유선암여HER-2과표체유선암환자적l림상병리특정급예후.방법 회고1997년1월지2007년1월행수술치료적725례원발성유선암적림상자료,근거면역조화염색결과학정삼음성화HER-2과표체유선암표형,병대2조적림상병이학자료진행비교화생존분석.결과 삼음성화HER-2과표체유선암분별점12.29%급24.96%;삼음성유선암유악성종류가족사자점18.4%,명현고우HER-2과표체조적5.5%(P=0.001);조직학분급3급자점54.0%,야고우HER-2과표체조42.0%(P=0.01);삼음성유선암(74.7%)교HER-2과표체유선암(64.6%)경역발생림파결전이(P=0.045);재2년내복발、전이급뇌전이(분별위25.3%급8.0%)명현고우HER-2과표체유선암(분별위8.8%화2.2%)(P<0.05),기5년무병생존솔(55.6%)명현저우HER-2과표체유선암(69.8%)(P=0.041).2조재년령、월경상태、종류대소、병리분기、수술방식、병리류형、보조방화료、간폐골전이비례화총생존솔지간차이균무통계학의의(P>0.05).결론 여HER-2과표체유선암상비,삼음성유선암경다유악성종류가족사,종류악성도경고,경역발생림파결화뇌전이,무병생존기경단,예후차.
Objective To compare clinicopathological characteristics and prognosis between triple-negative and HER-2-overexpressed breast cancer patients.Methods From Jan.1997 to Jan.2007,data of 725 cases of primary breast cancer patients undergoing surgical treatment were analyzed.The patients were classified into triple-negative and HER-2-overexpressed phenotypes based on immunohistochemistry results.The clinicopathological characteristics and survival of the 2 groups were compared.Results Of the 725 cases,triple-negative and HER-2-overexpressed phenotypes accounted for 12.29%and 24.96%respectively.Compared with HER-2-overexpressed group,the triple-negative group had significantly higher proportion of familial history of malignancy (18.4% vs 5.5%,P=0.001)and higher proportion of patients'histological grade reaching grade 3(54.0% vs 42.0%,P=0.01).There were more lymph node metastasis in triple-negative group than that in HER-2-overexpression group(N1+N2+N3:74.7%vs 64.6%,P=0.045).The recurrence and metastasis rate within 2 years and brain metastasis rate in triple-negative group were higher than those in HER-2-overexpressed group (25.3%,8.0%vs 8.8%,2.2%,respectively,P<0.05).The 5-year disease-free survival rate in triple-negative group was significantly lower than that in HER-2-overexpressed group(55.6%vs 69.8%,P=0.041).There was no statistical difference between the 2 groups in terms of age,menopausal status,tumor size,pathological stage,surgcal procedure,pathological type,adjuvant radio-chemotherapy,the proportion of metastasis to liver,lung and bone as well as overall survival rate(P>0.05).Conclusion Compared to HER-2-overexpressed group,patients with triple-negative breast cancer show higher rate of familial history of malignancy,and they are associated with higher histological grade and poor prognosis.