Clinicopathological Characteristics And Prognostic Analysis Of Each Subtype Of Triple-negative Breast Cancer Patients

Objective:Triple-negative breast cancer accounts for about 15-20% of all breast cancer.It is a heterogeneous disease with large differences in morphology,molecular,clinical manifestations,and treatment prognosis.Therefore,the classification of triple-negative breast cancer patients into homogeneous subgroups is of great significance for further understanding of TNBC clinical behavior and personalized treatment.In 2020,the latest research result from the Cancer Center of Fudan University is published,that is,the use of immunohistochemistry to classify TNBC patients to compensate for the large amount of material and financial resources used to classify TNBC patients through microarray and other methods.It is not conducive to promotion and cannot be used for the general public.In this study,four biomakers of AR/CD8/FOXC1/DCLK1 were used to classify patients with triple-negative breast cancer,and the clinicopathological characteristics and prognosis differences of patients of each subtype were analyzed.Provide a basis for the clinical promotion and treatment of this model.Make clinical TNBC precise targeted therapy possible,thereby improving the overall prognosis of the TNBC population。Methods:This study collected patients with primary triple-negative breast cancer confirmed by Shanxi Provincial People’s Hospital who underwent surgical treatment in our hospital from January 2012 to December 2014,and collected their clinical pathological data and prognosis.After screening,97 patients were finally enrolled in the group,and the enrolled patients were classified by immunohistochemistry and followed up.The general information of TNBC patients is described using the composition ratio;the general information of TNBC patients is compared with the distribution of IHC subtypes among different groups using the chi-square test;the overall survival time and recurrence-free survival time are described using the 25 th,50th,and 75 th percentiles.Log-rank test was used for comparison between groups,the overall survival curve and recurrence-free survival curve were estimated by Kaplan-Meier method,and the multivariate analysis of relapse-free survival(RFS)and overall survival(OS)was adopted Cox proportional hazards regression model.SPSS 22.0 software was used to draw overall survival curve and recurrence-free survival curve;R 3.6.1 software was used to draw fan chart and forest diagram.Results:1.97 TNBC patients were classified by immunohistochemistry,and they were androgen receptor type(Luminal androgen receptor,LAR)(n = 24,24.7%),immunomodulatory type(Immunomodulatory,IM)(n=23,23.7%))Mesenchymal-like subtype(MES)(n = 13,13.7%),Basal-like and immune suppressed(BLIS)(n=27,27.8%),unspecified type(Unclassififiable,UC)(n=10,10.3%).2.In IHC-subtypes,there are differences in age,Ki67,pathological type distribution(P=0.018,P=0.02,P=0.019);the histological grade,surgical method,T grade,N grade,menstrual status and chemotherapy regimen are different There was no statistical difference in the distribution of IHC-subtypes(P>0.05).3.There are differences in OS between IHC subtypes(log-rank test,P<0.001),IHC-MES subtype has a higher risk of death than other subtypes,and IHC-LAR and IHC-IM have relatively better prognosis;IHC There are differences in RFS among subtypes(log-rank test,P<0.001),and IHC-MES subtypes have a higher risk of recurrence.4.Univariate analysis showed that age,ki67,surgical methods,and N grade were related to local recurrence or distant metastasis in TNBC patients(P<0.05),compared with patients with age <50 years,Ki67≤30%,and low N grade,Patients with age ≥50 years,Ki67 >30%,and high N grade have a shorter recurrence-free survival period.Univariate analysis showed that age,ki67,pathological type,surgical methods,and N grade were related to the death of TNBC patients(P<0.05).The overall survival of patients with age <50 years,Ki67 ≤30%,modified radical resection,and low N grade Longer period.5.According to Cox multivariate analysis,Ki 67,N grade and IHC-type are independent prognostic factors that affect RFS of TNBC patients;operation method,N grade and IHC-type are independent prognostic factors that affect OS in TNBC patients.Conclusion:IHC-type has reproducibility,robustness,effectiveness and feasibility,and can be used in clinical promotion.Among the subtypes,the MES type is more prone to end-point events such as local recurrence,distant metastasis,and death.The RFS of IM type is better than other subtypes.The long-term survival of LAR patients is better than that of other subtypes.