Clinicopathological and Prognostic Characteristics of Malaysian Triple Negative Breast Cancer Patients Undergoing TAC Chemotherapy Regimen
Clinicopathological and Prognostic Characteristics of Malaysian Triple Negative Breast Cancer Patients Undergoing TAC Chemotherapy Regimen
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DOI：
10.1155/2020/8424365
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发表时间：
2020-04-01
影响因子：
1.9
通讯作者：
Ankathil, Ravindran
中科院分区：
文献类型：
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作者：
Aziz, Ahmad Aizat Abdul;Salleh, Md Salzihan Md;Ankathil, Ravindran
三阴性乳腺癌（TNBC）与侵袭性肿瘤表型和诊断后早期肿瘤复发有关。一般来说，肿瘤大小、患者诊断时年龄、肿瘤组织学亚型、分级和分期、淋巴结受累和绝经状态等临床病理学特征通常用于预测疾病进展、复发前景和治疗反应。马来西亚 TNBC 患者的临床病理特征的预后价值有限。因此，本研究旨在调查接受 TAC 化疗的马来西亚 TNBC 患者的临床病理特征与无病生存期 (DFS) 和总生存期 (OS) 的关联。招募了七十六 (76) 名免疫组织化学确诊的 TNBC 患者。收集并记录TNBC患者的临床病理特征。采用 Kaplan-Meier 法和对数秩法以及 Cox 比例风险回归模型来评估 TNBC 患者的生存率。在 76 名 TNBC 患者中，25 名患者具有化疗耐药性，51 名患者对 TAC 化疗方案有化学反应。 TNBC 患者的总体 5 年累积 DFS 和 OS 分别为 63.5% 和 76.3%。多变量 Cox 分析表明，髓质和化生组织学亚型以及腋窝淋巴结转移阳性是与复发相关的重要预后因素，调整后的 HR：5.76、95% CI：2.35、14.08 和调整后的 HR：3.55、95% CI：1.44、8.74。此外，具有髓质和化生组织学亚型且腋窝淋巴结转移阳性的TNBC患者比具有浸润性导管癌和腋窝淋巴结转移阴性的患者具有更高的死亡风险（调整后的HR：8.30，95％CI：2.38，28.96和调整后的HR：6.12，95％CI：1.32，28.42）。我们的结果证明了髓质和化生组织学亚型以及腋窝淋巴结转移阳性作为预测 TNBC 患者复发和生存的潜在生物标志物的潜在用途。这需要进一步研究强化化疗以及确定和开发靶向治疗，以减少 TNBC 患者的复发并提高生存率。
Triple negative breast cancer (TNBC) is associated with aggressive tumour phenotype and early tumour relapse following diagnosis. Generally, clinicopathological features such as tumour size, patient's age at diagnosis, tumour histology subtypes, grade and stage, involvement of lymph nodes, and menopausal status are commonly used for predicting disease progression, prospects of recurrence, and treatment response. Prognostic value of clinicopathological features on Malaysian TNBC patients is limited. Thus, this study is aimed at investigating the association of clinicopathological features on disease-free survival (DFS) and overall survival (OS) of Malaysian TNBC patients undergoing TAC chemotherapy. Seventy-six (76) immunohistochemistry-confirmed TNBC patients were recruited. The clinicopathological features of TNBC patients were collected and recorded. Kaplan-Meier and log-rank followed by a Cox proportional hazard regression model were performed to evaluate the TNBC patients' survival. Out of 76 TNBC patients, 25 were chemoresistant and 51 were chemoresponders to the TAC chemotherapy regimen. The overall 5-year cumulative DFS and OS of TNBC patients were 63.5% and 76.3%, respectively. Multivariate Cox analysis demonstrated that medullary and metaplastic histology subtypes and positive axillary lymph node metastasis were significant prognostic factors associated with relapse with adjusted HR: 5.76, 95% CI: 2.35, 14.08 and adjusted HR: 3.55, 95% CI: 1.44, 8.74, respectively. Moreover, TNBC patients with medullary and metaplastic histology subtypes and positive axillary lymph node metastases had a higher risk to death than patients who had infiltrating ductal carcinoma and negative axillary lymph node metastasis (adjusted HR: 8.30, 95% CI: 2.38, 28.96 and adjusted HR: 6.12, 95% CI: 1.32, 28.42, respectively). Our results demonstrate the potential use of medullary and metaplastic histology subtype and positive axillary lymph node metastasis as a potential biomarker in predicting relapse and survival of the TNBC patients. This warrants further studies on intensification of chemotherapy and also identification and development of targeted therapy to reduce relapses and improve survival of TNBC patients.