Clinicopathological And Prognostic Analysis Of TNBC Subtypes

Background: Studies have shown that TNBC（Triple-negative breast cancer）is highly heterogeneous and can be re-divided into different molecular subtypes.In recent years,FUSCC（Fudan University Shanghai Cancer Center）has put forward the concept of "Fudan classification" and developed a simple and economical IHC（Immunohistochemical）classification model,which provides a reference for the clinical research of TNBC.Objective: To study the clinicopathological features and prognosis of different subtypes of TNBC based on IHC classification model,and to verify the clinical feasibility of the model.Methods: The tumor tissue wax blocks of 98 patients with TNBC treated in the first affiliated Hospital of Bengbu Medical College from December 2011 to December 2016 were collected and divided into four groups by IHC: LAR subtype（AR+）,IM subtype（AR,CD8+）,BLIS subtype（AR-,CD8-,FOXC1+）and MES subtype（AR-,CD8-,FOXC1-,DCLK1+）.If it could not be classified,it would be marked as IHC-UC（AR-,CD8-,FOXC1-,DCLK1-）.Results: 90 of the 98 patients could be classified,including 23 cases of LAR subtype（25.56%）,29 cases of IM subtype（32.22%）,24 cases of BILS subtype（26.67%）and14 cases of MES subtype（15.56%）.There was no significant difference in age distribution,tumor diameter,number of positive lymph nodes,pathological grade,recurrence and metastasis among the four types.There was significant difference in prognosis between IM subtype and MES subtype.Cox multivariate regression analysis showed that the number of positive lymph nodes was an independent risk factor for 5-year DFS and 5-year OS in patients with TNBC.Conclusion: There are differences in the expression of Ki-67 and p53 among the four groups of TNBC.The expression of p53 and Ki-67 is lower in IM type,while the expression level of Ki-67 and p53 is relatively higher in MES subtype.The prognosis of patients with IM subtype is good,while that of MES subtype is poor.The number of positive lymph nodes is an independent risk factor affecting the 5-year prognosis of patients with TNBC.