Objective: To investigate the clinical relevance of prognostic staging according to the AJCC Breast Cancer Staging System, Eighth Edition for evaluation of the prognosis of triple-negative breast cancer. Methods: The clinical data of 293 patients with triple-negative breast cancer who were treated at the Breast Disease Center, Peking University First Hospital, between January 2008 and December 2014, were retrospectively analyzed. All patients were female, with age of 53(16) years (M(Q(R))). The patients were staged according to the AJCC Breast Cancer Staging System, Eighth Edition. Survival analysis was performed by Kaplan-Meier method and Log-rank test. The role of clinical staging and prognostic staging in prognostic evaluation was investigated. Results: In all, 293 patients with triple-negative invasive breast cancer with complete clinical data and follow-up data were treated over a 7-year period. The follow-up time was 64.5(32.8) months, the 5-year overall survival (OS) rate was 83.9%, and the 5-year disease-free survival (DFS) rate was 84.1%. The results showed that clinical staging and prognostic staging were correlated with the DFS rate and OS rate of patients with triple-negative breast cancer (χ(2) were 15.395 to 50.084,P=0.00). However, these two staging systems yielded different results. The prognostic stage of 91.8%(269/293) patients was higher than that of the original anatomical stage. There were significant differences in disease-free survival rate (χ(2)=22.357,P=0.00) and overall survival rate (χ(2)=50.084, P=0.00) among patients with different clinical stages. There were significant differences in disease-free survival rate (χ(2)=15.395,P=0.00) and overall survival rate (χ(2)=29.187,P=0.00)among patients with different prognostic stages. Conclusions: The prognostic stage according to the AJCC Breast Cancer Staging System, Eighth Edition complements the clinical stage. It has a good predictive value for the prognosis of triple-negative breast cancer.
目的： 探讨AJCC第8版乳腺癌预后分期系统对三阴型乳腺癌预后评价的临床意义。 方法： 回顾性分析2008年1月至2014年12月北京大学第一医院乳腺疾病中心收治的293例临床资料及随访信息完整的三阴型乳腺癌患者的临床资料。患者均为女性，年龄53（16）岁[M（Q(R)）]。按照AJCC第8版乳腺癌分期系统对患者进行预后评价。采用Kaplan-Meier曲线进行生存分析，组间比较采用Log-rank检验，分析预后分期在预后评价中的意义。 结果： 293例患者随访64.5（32.8）个月，5年无病生存率为84.1%，5年总体生存率为83.9%。预后分期与解剖学分期对患者的分期评价存在差异，91.8%（269/293）的患者预后分期高于原解剖学分期。不同解剖学分期患者的无病生存率差异有统计学意义（χ(2)=22.357，P=0.00），总体生存率差异也有统计学意义（χ(2)=50.084，P=0.00）。不同预后分期的无病生存率差异有统计学意义（χ(2)=15.395，P=0.00），总体生存率差异也有统计学意义（χ(2)=29.187，P=0.00）。 结论： AJCC第8版乳腺癌预后分期是解剖学分期的重要补充，对三阴型乳腺癌预测预后和制定治疗决策具有重要的参考价值。.
Keywords: Breast neoplasms; Neoplasm staging; Prognosis.