The Pathological Features Of Triple Negative Breast Cancer And The Clinical Significance Of The Expression Of CK5/6,E-cad And EGFR

ObjectiveTo investigate the clinical pathological features of triple negative breast cancer(TNBC),and to study the relationship between the expression of cytokeratin 5/6(CK5/6),E-cadherin(E-cad),epidermal growth factor receptor(EGFR)and the clinical pathological features and prognosis of TNBC,which provide the reference for clinical diagnosis and treatment of TNBC.MethodsThe clinical pathological data,including age,tumor size,TNM stage,pathological type,lymph node status,tumor tissue differentiation,menopausal status,and family history were analyzed from patients with 62 cases of TNBC and 341 cases of Non-TNBC.The expression of CK5/6,E-cad and EGFR in tumor tissues was detected by histochemical methods.The expression differences of CK5/6,E-cad and EGFR in TNBC and Non-TNBC were analyzed.The clinical pathological parameters and prognosis,such as local recurrence rate,metastasis rate,5-year survival rate,and 5-year period,were analyzed.The relationship between gene expression and clinical data were also analyzed by statistical method.ResultsAmong 403 breast cancers patients,the number of TNBC and Non-TNBC were 62(15.4%)and 341(84.6%)respectively.Compared with Non-TNBC,TNBC patients had young age,large tumor,high TNM stage,lymph node metastasis rate and family history of breast cancer and poor prognosis.The positive rates of CK5/6,EGFR and E-cad were 77.4%(48/62),7.0%(24/341),88.7%(55/62)in TNBC patients and 57.5%(196/ 341),29.0%(18/62),82.4%(281/341)in Non-TNBC patients.The difference was statistically significant(P<0.05).In TNBC patients,there was a significant positive correlation between CK5/6 and EGFR expression.The expression of E-cad had a significant negative correlation with the expression of CK5/6 and EGFR(P<0.05).There was a relationship between the expression of CK5/6 and E-cad and the patient’s survival time(P<0.05).The expressions of CK5/6,E-cad and EGFR were significantly associated with TNBC tumor size,lymph node metastasis,and histological grade(P<0.05),but not associated with age,menstrual status,TNM stage,and family history of breast cancer(P>0.05).The recurrence rate,metastasis rate,5-year survival rate,and 5-year disease-free survival rate of TNBC patients were significantly lower than that of Non-TNBC(P<0.05).The 5-year survival rate of TNBC patients was significantly associated with lymph node metastasis,tumor size,histological grade,pathological type,and high expression of E-cad(P<0.05),but not associated with age,TNM stage,menstrual status,and family history of breast cancer(P>0.05).High tumor ≥2cm,invasive ductal carcinoma,and high expression of E-cad were independent factors in the5-year survival rate of TNBC(P<0.05).ConclusionTNBC and Non-TNBC are two different breast cancer subtypes with significant differences in clinical pathology,prognosis and molecular phenotypes,which maybe participated in the activation of signaling pathways,such as CK5/6,EGFR,and E-cad and so on.The expression of CK5/6,E-cad and EGFR can be used as indicators of TNBC lymph node metastasis and tumor differentiation.The tumor size ≥2 cm,invasive ductal carcinoma,and high E-cad expression were independent factors in evaluating the 5-year survival rate of TNBC.