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目的 分析转移性三阴乳腺癌(MTNBC)患者临床病理学特征及生存状态,探讨其复发转移部位尤其脑转移特点.方法 收集了 2002年1月至2004年12月天津医科大学肿瘤医院收治的120例MTNBC患者的临床资料,回顾性分析其临床病理学特征及生存情况.采用SPSS 13.0统计软件进行分析,取P＜0.05差异有统计学意义.结果 至随访截止期,120例MTNBC患者转移后中位生存时间为22个月,死亡79例(65.8%).肺、肝、脑是常见的转移部位,分别为70例(58.3%)、50例(41.7%)和49例(40.8%).其中22例(18.3%)首发转移部位为脑转移,其生存期较非脑转移患者明显缩短,转移后中位生存时间为8个月和31个月(P=0.000).结论 MTNBC患者预后差,其中脑转移较非脑转移明显影响本组患者的预后,探索新的更有效的治疗手段将成为今后的研究热点.

Objective To analyze the clinical features and survival for patients with metastatic triple negative breast cancer ( MTNBC), especially such a metastatic site as brain. Methods The clinical data and survival status of 120 cases of operable MTNBC treated at our hospital from January 2002 to December 2004 were collected. SPSS 13.0 software was used for statistic treatment. Statistical significance was considered at P < 0. 05. Results At the time of last follow-up, the median time after metastasis was 22 months. Nine deaths(65.8% )were recorded. In terms of all metastatic sites (initial + subsequent), lung (58. 3% ), liver(41.7% )and brain (40. 8% ) were most common sites. The patients with brain metastasis had a worse survival than those with non-brain metastases. Twenty-two ( 18. 33% ) patients were found to have brain metastasis at the time of first metastatic presentation. The initial metastatic site in patients with brain metastasis had a worse survival than those with non-brain metastases. The median survival time after metastasis was 8 and 31 months respectively ( P = 0. 000). Conclusion Triple-negative breast cancer is associated with a poor survival after metastases. The patients with brain metastases have a worse survival than those with non-brain metastases. New treatment strategies are needed.