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目的探讨非激素依赖性乳腺癌的临床病理特征及预后相关因素。方法收集213例1999年1月至2006年12月术前未接受任何治疗的ER、PR阴性乳腺癌患者的临床、病理资料,随访追踪患者生存信息。应用组织微阵列技术、免疫组织化学染色及免疫荧光技术,检测HER2、CK5/6、CK14、EGFR、p53、p63、Vimentin标记物的表达,依据免疫组织化学及免疫荧光检测结果,将213例非激素依赖性乳腺癌进行分类,分析非激素依赖性乳腺癌的临床病理特征及预后因素。结果 213例非激素依赖性乳腺癌中纯HER2过表达型56例(26.3%),基底细胞样型93例(43.7%),Basal-HER2型19例(8.9%),全阴型45例(21.1%)。基底细胞样型乳腺癌患者的3、5、10年无病生存率(DFS)分别为80.6%、77.5%、74.2%;3、5、10年总生存率(OS)分别为82.7%、79.6%、74.1%。在非激素依赖性乳腺癌中基底细胞样型乳腺癌与非基底细胞样型乳腺癌的5年总体生存率相比无明显差异(P>0.05)。基底细胞样型乳腺癌手术时有腋窝淋巴结转移与无转移者5年生存率差异有显著性(64.1%对88.4%,P<0.05)。结论基底细胞样型乳腺癌具有独特的免疫表型及临床病理特征,总体预后与其他类型的非激素依赖性乳腺癌无明显差异,但手术时有无腋窝淋巴结转移对预后影响较大。
Objective To investigate the clinicopathological features and prognostic factors of non-hormone-dependent breast cancer. Methods The clinical and pathological data of 213 patients with ER, PR-negative breast cancer who had not received any treatment from January 1999 to December 2006 were collected. The patients’ survival information was followed up. The expression of HER2, CK5 / 6, CK14, EGFR, p53, p63 and Vimentin was detected by tissue microarray, immunohistochemistry and immunofluorescence staining. According to the results of immunohistochemistry and immunofluorescence, 213 cases of non- Hormone-dependent breast cancer classification, analysis of non-hormone-dependent breast cancer clinicopathological features and prognostic factors. Results In 213 cases of non-hormone-dependent breast cancer, 56 cases (26.3%) of pure HER2 overexpression, 93 cases (43.7%) of basal cell type, 19 cases (Basal-HER2 type) 21.1%). The 3, 5 and 10 year disease-free survival rates (DFS) of patients with basal-like breast cancer were 80.6%, 77.5% and 74.2%, respectively. The OS rates at 3, 5 and 10 years were 82.7% and 79.6% %, 74.1%. There was no significant difference in 5-year overall survival rate between basal-like breast cancer and non-basal cell-like breast cancer in hormone-independent breast cancer (P> 0.05). The 5-year survival rate of patients with basal-like breast cancer with axillary lymph node metastasis and without metastasis was significantly different (64.1% vs 88.4%, P <0.05). Conclusions Basaloid breast cancer has unique immunophenotype and clinicopathological features. The overall prognosis is not significantly different from other types of hormone-independent breast cancer. However, the presence or absence of axillary lymph node metastasis during surgery strongly influences prognosis.