| ObjectiveThe triple-negative subtype of breast cancers is defined by a lack of expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2). Triple negative breast cancer as a specific subgroup of breast cancer is a high risk breast cancer. Compared with non-triple negative breast cancer, triple negative breast cancer has an increased possibility of local recurrence or distant metastasis, leading to a poorer prognosis. The most common histological types were ductal carcinomas of no specific type, with large masses, high grade. In addition, associations were found with loss of expression of androgen receptor and E-cadherin, cyclinD and positive expression of basal cyto-keratins (CK5/6, CK17), P-cadherin, p53, and EGFR. In this study, we investigated the high-risk group of breast cancer with the triple-negative phenotype (estrogen receptor-negative, progesterone receptor-negative, and Her2-negative) that lacks the benefit of specific therapy that targets these proteins to characterize and identify additional prognostic markers(MMP-2, E-cadherin, p53) that can identify tumors with more aggressive behavior.Methods1,The clinicopathologic data of 1264 cases of operable breast cancer seen in our hospital from January 2004 to January 2005 were analyzed. Statistical analysis was performed using SPSS 13.0 statistical software. We examined the association between triple-negative phenotype and other clinicopathologic variables using chi-squared test, and chi-squared test for trend as appropriate. The association with survival was analyzed initially by Kaplan-Meier plot and log-rank test and also with Cox regression analysis to adjust for other prognostic indicators. A P-value of<.05 was considered significant. The clinicopathologic characteristics, recurrence and survival of the patients were summarized.2,96 of Breast cancer tissue microarrays were prepared and immunohistochemically stained for estrogen receptor, progesterone receptor, Her2, MMP-2, E-cadherin and p53 in a blind fashion. The clinicopathologic data of 96 cases were analyzed. Statistical analysis was performed using SPSS 13.0 statistical software. We examined the significance of different prognostic markers using chi-squared test, and chi-squared test for trend as appropriate. The association with survival was analyzed initially by Kaplan-Meier plot and log-rank test and also with Cox regression analysis to adjust for other prognostic indicators. A P-value of<.05 was considered significant.Result1,Of the 1264 patients,246(19.46%) were confirmed to be triple negative breast cancer. Triple negative breast cancer was commonly seen in young patients(< 35,8.54%,P=0.0003) with large masses(=5cm,11.79%,P=0.008), a high proportion of lymph node metastasis(58.13%, P=0.013),high grade 111(20.73%,P=0.0002) and familial history of breast cancer at diagnosis (8.13%,P=0.023). The rate of local recurrence or distant metastasis in the triple negative group was higher than in the non-triple negative group (20.33%,P=0.003). The 5-year disease-free and overall survival rates were significantly lower in triple negative breast cancer patients than in non-triple negative breast cancer patients (79.67%,P=0.003;89.84%,P=0.0001).2,The 5-year disease-free and overall survival rates were significantly lower in young triple negative breast cancer patients with large masses, high gradeâ…¢, positive of lymph node metastasis,negative E-cadherin, positive MMP-2 and p53. In the triple-negative breast cancer patients, p53 status had statistically significant independent prognostic value for relapse-free survival and overall survival.Conclusion1,Triple negative breast cancer is a high risk breast cancer, Compared with non-triple negative breast cancer, triple negative breast cancer has an increased possibility of local recurrence or distant metastasis, leading to a poorer prognosis.2,p53 status could be a specific prognostic factor in triple-negative breast cancer patients. |
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