1、1Discussion on the Clinical Pathological Characteristics and Prognosis Analysis of Triple-negative BrAbstract. Objective: The clinical characteristics of the cases with triple-negative breast cancer were studied, and also the prognosis of this cancer was comprehensively analyzed. Methods: The materi
2、als of 120 cases with triple-negative breast cancer, receiving a treatment in Hongqi Hospital from October 2011 to October 2012, were randomly selected; the clinical conditions of these cases were retrospectively analyzed; prognosis analysis was made to the characteristics of the cases with triple-n
3、egative breast cancer after a definite diagnosis. When these cases were definitely diagnosed, 100 cases were classified into 4 groups according to estrogen receptor, progesterone receptor, and human epidermal growth factor receptor, and also prognosis analysis was made to all of them. Results: the c
4、haracteristics of the cases with triple-negative breast cancer were very complex; compared with other types of breast cancer, triple-negative breast cancer features high recurrence risk, long course of disease, and difficult treatment. Conclusion: The prognosis analysis of triple-2negative breast ca
5、ncer is helpful for guiding clinical treatment and reducing all kinds of risks caused by the recurrence of disease. Key words: Estrogen Receptor; Progesterone Receptor; Human Epidermal Growth Factor; Pathological Mechanism; Prognosis Analysis Introduction In recent years, the incidence of breast can
6、cer among Chinese women continues to rise by 5%-10% annually, making the normal healthy condition of Chinese women seriously affected. Along with the in-depth development of the studies on clinical cases, some new breast cancers have been discovered and triple-negative breast cancer (TNBC) can be co
7、mmonly seen among them. TNBC is a complex breast cancer clinically, in which estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2) were negative. The clinical characteristics of the cases are uneasy to control, and therefore the prognosis analysis on t
8、he patients is very crucial. In this paper, using120 cases with TNBC treated in Hongqi Hospital as clinical material, an analysis is conducted as follows. 3Materials and Methods Clinical Material. The materials of 120 cases with triple-negative breast cancer, receiving a treatment in Hongqi Hospital
9、 from October 2011 to October 2012, were randomly selected; the course of disease was 15 years, so the average time was 3.2 years. The age of 120 cases was in 3060 years old, so their average age was 411.8 years old. Among estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth
10、 factor receptor (HER2), all these patients were negative in one, two or above of them. All the120 cases received an operative treatment, which is specifically as follows: 20 cases received a simple mastectomy, 90 cases received a modified radical mastectomy, and 10 cases received other operations s
11、uch as extensive radical mastectomy and breast conserving surgery. Methods Grouping. The negative conditions of the 120 cases with breast cancer were classified in details. According to diagnosis results, these cases were divided into 4 groups: group A was patients with negative estrogen receptor (E
12、R); group B was patients with negative progesterone receptor (PR); group C was patients with negative human epidermal growth factor receptor (HER2); group D was patients with the above 4three negative receptors. Investigation. All the 120 cases were visited and investigated continuously for 5 years.
13、 The purpose of the visit and investigation was to emphatically classify the recurrence, metastasis and death conditions of the patients, and simultaneously relevant specific data was recorded. Statistics Processing. P value was verified with PPMS 1.5 statistical software. Results After detailed ins
14、pection and diagnosis, the 120 cases with breast cancer were divided into 4 groups: Group A with 23 cases (19.1%), Group B with 30 cases (25.0%), Group C with 27 cases (22.5%), and Group D with 40 cases (33.4%). The recurrence, metastasis and death conditions of the patients in the 4 groups were sta
15、tistically classified, as shown in table 1. From table 1, it is known that the 120 cases were divided into 4 groups (group A, group B, group C, and group D); after a continuous returning visit of 5 years, it was finally concluded that the pathological condition of group D was poor as a whole. Only 3
16、 cases in group D were cured, and thus the cure rate was 7.5% lower than that of group A and group C, but higher than that of group B. The recurrence rate, metastasis rate, and 5death rate of group D were higher than those of other 3 groups, and especially the final death rate of group D reached 12.
17、5%, which was 5% higher than that of other 3 groups. The data fully indicates that the conditions of the patients with TNBC are very complex, and the pathological changes such as recurrence and metastasis are easy to emerge in the stage of clinic treatment or future recuperation, and the patients wi
18、th serious conditions will die ultimately. Discussion Breast cancer is a malignant tumor disease commonly seen among women, and will threaten life if it is processed improperly. In early days, because the study of clinical pathology was not profound, some new characteristics of the patients with bre
19、ast cancer were not discovered, and subsequently the treatment effect on the patients was affected. In the new study of pathology theory, foreign research results are introduced, and also the cases with breast cancer are systematically classified, so that the triple-negative breast cancer (TNBC) as
20、a special type is proposed. Because of the obvious special characteristics of TNBC in pathology, the prognosis analysis of TNBC should be studied emphatically in the clinical area, so that scientific guidance can be provided 6for the treatment and recuperation in the future. Characteristics of the C
21、ases with TNBC Age Characteristics. The characteristics in age are a focused standard in the study of TNBC, and play a guiding role in the clinical disease prognosis of patients. Health survey from society shows that womens disease incidence is not only limited to multiple types, but also trends to
22、be “younger“. The average age of the patients in the 4 groups of this study was about 41 years old, 1-2 years old younger than that of the patients collected in the early medical materials; the average age of the patients in Group D was more than 38.2 years. All these suggest that the TNBC emerge on
23、 younger women. Tumor Characteristics. From clinical inspection, it is found that the patients in the 4 groups were significantly different in the size of tumor. Because estrogen receptor, progesterone receptor, human epidermal growth factor receptor were significantly different in the course of dis
24、ease, the tumor size from the final inspection was with comparability. The actual conditions are as follows: the size of tumor of Group A was 0.61cm, the size of tumor of Group B was 0.81.2 cm, the size of tumor of Group C was 11.27 cm, and the size of tumor of Group D was 25.2cm; invasive ductal ca
25、rcinoma was 7very common, occupying as high as 83%. Pathological Changes Characteristics. In the continuous five-year visit and investigation on the patients of the 4 groups, pathological changes of different degree emerged on all of them, and tended to be more apparent with the passage of time. In
26、this study, three special pathological changes (recurrence, metastasis, and death) were emphatically classified, and the pathological changes of TNBC were the most serious. According to relevant data, the recurrence rate of TNBC is the highest in 3 years generally, and the proportion can reach about
27、 80% and also patients condition is different after the recurrence of TNBC. In addition, the pathological changes of ER, PR, and HER2 were also relatively obvious, and especially the lymph node metastasis makes patients condition more serious. Prognosis Analysis. TNBC refers to a special breast canc
28、er with negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2). Patients with TNBC account for about 15% of total breast cancers patients. Many biological characteristics of TNBC are similar to those of basal cell breast cancer, but the two type
29、s of cancers are different in some gene expression patterns and 8immunophenotyping, and thus they cant be completely equal. Because of endocrine and anti-HER2 treatment targets, there has been no specific standard treatment plans for TNBC yet. In the material, the average age of the patients in Grou
30、p D was younger and most of the patients were without menopause. This also keeps consistent with relevant studies. The material also showed that the tumor size of the patients in Group D was large, and the comparison of Group D with Group A, B and C was of statistical significance (P0.05), suggestin
31、g the tumor of TNBC grew quickly and owned a powerful invasion, and also the lymph node metastasis rate of Group D was high no matter how big the tumor and was of statistical significance compared with Group A, B and C (P0.05). For most patients with breast cancer, greater tumor suggests a higher ly
32、mph node metastasis rate. The tumor size of TNBC is uncorrelated with the state of lymph node, and the tumor with small diameter owns a higher lymph node positive rate. Because the state of lymph node and the size of tumor are two major factors affecting the survival of patients, they indirectly ind
33、icate the prognosis of TNBC is not ideal. Such a biological characteristic is of clinical guiding significance, suggesting the patients with TNBC should be treated early, actively and powerfully and also provided with new adjuvant 9therapy. Suggestions on Treatment In the clinical treatment of TNBC,
34、 it is necessary to combine with the characteristics of cases and the prognosis analysis results, so that the final treatment effect can be ensured. According to the existing medical conditions at home and abroad, the treatment of TNBC should give priority to chemotherapy and also cooperate with rel
35、evant drug treatment measures for recuperation. At present, the domestic and international studies mainly focus on the selection of chemotherapy drugs such as anthracycline-based medicine, yew-based medicine, ipsapirone and platinum drugs. During the period of the actual treatment, it is necessary f
36、or patients to learn the self-control and self-protection measures in addition to the recuperating plans provided by doctors, so that the recurrence of disease can be controlled from life habits, eating habits and psychological state as much as possible, and also the recovery of patients can be acce
37、lerated through regular drug use. Conclusion In short, the conditions of the cases with TNBC are very complex, and the pathological changes such as recurrence and metastasis are easy to emerge in the stage of clinic treatment 10or future recuperation. In this paper, the analysis result of Group D sh
38、owed TNBC tended to be diversified in pathological characteristics; after a five-year visiting and investigation on these patients, the overall incidence rate of TNBC was high in 5 years and so was the pathological metastasis rate. Thus, high importance should be attached to the prevention and contr
39、ol processing of the disease. Combined with the data obtained in this study and the prognosis result judgment of TNBC, it is known that the recurrence rate of TNBC is higher than that of the breast cancers with only one negative receptor and so is the death risk. This requires medical personnel to m
40、ake feasible treatment plans for reducing the harms caused by tumor recurrence or metastasis. References 1 Hicks DG,Short SM,Prescott NL,et al. Breast Cancers with Brain Metas-tases Are More Likely to be Estrogen Receptor Negative, Express the Basal Cytokeratin CK5/6, and Over-express HER2 or EGFR (J). The American Journal of Surgical Pathology, 2006. 2 Liedtke C, Mazouni C, Hess KR, et al. Response to Neoadjuvant Therapy and Long-term Survival in Patients with Triple-negative Breast Cancer J. Journal of Clinical Oncology,
