Analysis Of Prognostic Factors On Survival And Clinicopathological Features In Patients With Triple-negative Breast Cancer

ObjectiveAnalysis of prognostic factors on survival and clinicopathological features in patientswith triple-negative breast cancerMethodsThe date of99cases of TNBC patients who had received surgery treatment,withcomplete follow-up in the Dalian medical univerctiy from February2002to April2013was collected, all the cases were confirmed by histopathological examination, all ofthem were not receiving preoperative radiotherapy,chemotherapy and other treatments,and46cases of adjacent tissues (control group).the clinicopathologic data including age,lymph node metastasis,tumor size,clinical stage, histological grade, a database wasestablished.all the patients were followed-up by medical records and telephone,understanding the patient’s postoperative recovery and survival, Kaplan-Meier methodwas used to assess the survival rate, long-rank test was used to make monofactorialcomparison, finally Cox proportional hazards regression models was used to makemultifactorial analysis.with P<0.05as the significance test level. Theimmunohistochemistry assay was used for assaying the expressions ofGRP94,VEGF,HIF-1, and scored them under high-power microscopy. χ2test was usedfor statistical analysis, Kaplan-Meier method was used to assess the survival rate,long-rank test was used to make monofactorial comparison, finally Cox proportionalhazards regression models was used to make multifactorial analysis.Level ofsignificance was set to0.05. Results1.The date of TNBC patients’clinic-pathological distribution：1.199cases of TNBC patients age from30to79, average age58.879±16.263, median63.5, age distribution (years):<60has56samples(56.57%),≥60has43samples(43.43%)lymph node status: lymph node non-metastasis75samples（75.76%）, lymph nodemetastasis24samples（24.24%）, tumor size(cm):2～5has64samples（64.65%）,＞5has4samples（4.04%）,<2has31samples（31.31%）,Clinical TNM stagedistribution: majority of the samples are in II and III stage. There are34samples(34.34%),13samples (13.13%),7samples (7.07%), in stage II, III, and IV respectively.histological grade：I stage has11samples（11.11%）, IIstage has49samples（49.50%）,III stage has39samples（29.39%）.1.2Univariate analysis showed that age, lymph node metastasis,clinical stage can ’timpact on overall survival in TNBC patients (p>0.05). tumor size and histological gradeshow remarkable differences（p<0.05）.2. The express of GRP94, VEGF, HIF-1protein in TNBC and adjacent tissues andunivariate analysis2.1In the99cases of TNBC patients, The positive express rate of GRP94protein incarcinoma is69.70%（69/99）, miss rate30.30%（30/99）;the positive express rate of46samples adjacent tissues is13.04%（6/46）,miss rate86.96%（40/46）. There areprominent differences between the positive express rate of GRP94protein in carcinomatissues and paraneoplastic tissues (χ2=37.606，p<0.0001). Meanwhile, there is not adirect relationship between carcinoma and adjacent tissues classification （γ=-1，p<0.05）.2.2In the99cases of TNBC patients, The positive express rate of VEGF protein incarcinoma is53.54%（53/99）, miss rate46.46%（46/99）;the positive express rate of46samples adjacent tissues is26.09%（12/46）,miss rate73.91%（34/46）. There areprominent differences between the positive express rate of VEGF protein incarcinoma tissues and paraneoplastic tissues (χ2=9.236，p=0.0024). Meanwhile, there isnot a direct relationship between carcinoma and adjacent tissues classification （γ=-0.0259，p<0.05）.2.3In the99cases of TNBC patients, The positive express rate of HIF-1protein incarcinoma is50.51%（50/99）, miss rate49.49%（49/99）;the positive express rate of46samples adjacent tissues is49.49%（49/99）,miss rate80.43%（37/46）. There areprominent differences between the positive express rate of HIF-1protein in carcinomatissues and paraneoplastic tissues (χ2=5.296，p=0.0214). Meanwhile, there is not adirect relationship between carcinoma and adjacent tissues classification （γ=-0.3954，p<0.05）.2.4The expression of GRP94、VEGF、HIF-1protein in TNBC and its relationship withclinic-pathological characteristics.There is no prominent relationship between GRP94protein expression with patients’ages, tumor sizes, histological grade（p>0.05）. there are correlations between theexpressions and lymph node metastasis,clinical stage（p<0.05）There is no prominent relationship between VEGF protein expression with patients’ages, lymph node metastasis, clinical stage（p>0.05）. there are correlations between theexpressions and,histological grade, tumor sizes（p<0.05）There is no prominent relationship between HIF-1protein expression with patients’ages, lymph node metastasis, clinical stage（p>0.05）. there are correlations between theexpressions and,histological grade, tumor sizes（p<0.05）2.5The relationship between GRP94、VEGF、HIF-1protein and univariate analysis inTNBCKaplan-Meier method was used to assess the survival rate, long-rank test was used tomake monofactorial comparison, GRP94、VEGF、HIF-1protein impact on overallsurvival in TNBC patients.（p<0.05）二．Mutifactorial analysis between major variables and prognosis effectsThe univariate analysis, a statistically significant pathological grade, tumor size, put thetumor size and histological grade VEGF protein, GRP94protein, HIF-I protein whichhave Statistical significance in the univariate analysis into Cox proportional hazardsmodel review, Forward method for multivariate analysis. The outcomes of Cox proportional hazards regression model analysis indicate that GRP94、VEGF proteinhave statistical significance. They are independent prognostic factors that can affectHCC patients’prognosis（p<0.05）.Conclusion1.GRP94、 VEGF、 HIF-1protein expression in triple-negative breast cancer weresignificantly higher than in adjacent tissues, And the positive express rate of TNBCorganization and the adjacent tissues were negatively correlated. Examining GRP94,VEGF, HIF-1protein expression in TNBC can help in determining malignancy andillness progression.2. prognostic analysis showed that tumor size and histological grade GRP94、VEGF、HIF-1protein can impact on overall survival in TNBC patients.3. Mutifactorial analysis showed that GRP94、VEGF protein are independent prognosticfactors that can affect HCC patients’prognosis.