Clinicopathologic Characteristics And Prognostic Factors Of Triple Negatice Breast Cancer As Well As Prognostic Value Of RON And C-Met Expression

[Objective]We aim to analyze the clinicopathologic characteristics and present strategy for early stage triple negative breast cancer(TNBC),to explore the related factors which can influence the prognosis.To study the expression of the recepteur d’origine nantais(RON)and c-Met in the cancer and to assess the predictive value of them in terms of survival in TNBC.[Method](1)Clinicopathologic datas about TNBC operated in our center were collected and analyzed from January 2012 to December 2015.Follow-up was made.Then the patients were divided into groups according to the age or the axilly lymph node metastasis.The clinicopathologic characteristics were analyzed between different groups.The association of each characteristics with disease free survival(DFS)and overall survival(OS)was analyzed using Kaplan-Meier method with the log-rank test.Univariate analysis was used to assess significant differences in clinical characteristics,and the variables with P<0.10 were entered into multivariate analysis.(2)Immunohistochemical staining technique was used.The clinicopathologic characteristics were analyzed between high-expression RON/c-Met or not.Log-rank analysis was used to reveal the correlation between high-expression RON/c-Met and TNBC prognosis,survival was calculated using the Kaplan-Meier method.Univariate analysis showed the variables with P<0.10 were entered into multivariate analysis.[Result](1)A total of 207 patients were collected with compele datas,the young group were 14 patients(6.8%),the middle-aged group were 164 patients(79.2%),the elderly group were 29 patients(14.0%).The rate of breast conserving surgery(BCS)and Ki-67 were difference in the three groups.The young was 35.7%,the milddle-aged was 16.5%and the elderly was 0 about BCS.The rate of high Ki-67,the young was 100%,the middle-aged was 79.9%and the eldly was 65.5%.The patients with a breast cancer(BC)family history were all in the young and middle-aged.The patients in the young group all treated with adjuvent chemotherapy,and 85.7%patients chose anthracene plus taxus,while in the middle-aged the rate was 99.4%and 65.9%.In the elderly group,only 48.3%patients treated with adjuvent chemotherapy and only 13.8%patients chose anthracene plus taxus.There was no significant difference in the histologic grading,the mass size or the lymph node involved.The patients with a family history in the lymph node involved group(9.8%)were more than in the lymph node no-involved group(1.9%).Age,family history,diabetes,lymph node involved were significantly associated with DFS and OS with Univariate analysis,while adjuvant chemotherapy only significantly associated with OS.But,the Cox proportional multivariate hazard model for DFS and OS showed only lymph node involved,with diabetes and BC family history were independent prognostic factors.(2)A total of 187 effective pathological specimens were obtained finally.The rate of over-expression of RON was 33.7%(63 out of 187);c-Met was 34.2%(64 out of 187);RON and c-Met co-over-expression was 23.5%(44 out of 187).Over-expression RON was correlated with the tumor pathologic stages(P<0.05),and no association with patients’ age,BC family history,with hypertension or diabetes,mass size,histologic grading or lymph node involved.Over-expression c-Met found no relationship with the tumor clinicopathological characteristics.The association between RON or c-Met and survival outcomes was analyzed.Patients with over-expression RON showed significantly lower DFS and OS rate than those with no-over-expression RON(79.4%vs 90.3%,P=0.045;84.1%vs 95.8%,P=0.004),while over-expression c-Met only showed significantly lower OS rate(85.9%vs 95.9%,P=0.024).Multivariate Logistic regression analysis showed over-expression RON was a risk factor for DFS,and the HR was 4.334;over-expression c-Met was a risk factor for OS,and the HR was 3.38.[Conclusion](1)There were difference about the Ki-67,the choice of surgical methods and adjuvent chemotherapy among the patients of different age groups.The young patients were inclined to choose BCS and adjuvent chemtherapy with anthracene plus taxus.The paitents with BC family history may has a high incidence rate for lymph node metastasis.The progression of TNBC might be assioated with lymph node involved,daibetes and BC family history.(2)RON and c-Met were expressed in part of TNBC.Over-expression RON was assioated with the tumor pathologic stages,but no correlated with patients’ age,BC family history,with hypertension or diabetes,mass size,histologic grading or lymph node involved.RON expressed correlated with c-Met,but not Ki-67.Over-expression RON was significantly associated with DFS and OS,while over-expression c-Met only associated with OS.Over-expression RON was a risk factor for DFS,and over-expression c-Met was a risk factor for OS.RON and c-Met could be a convenient measured prognostic indicator for TNBC.