目的: 利用免疫组化的实验方法探索三阴型乳腺癌的病理特征及预后，检测表皮生长因子受体( Epidermal
growth factor receptor，EGFＲ) 、上皮性钙黏附蛋白( E－cadherin) 、雄激素受体( Androgen receptor，AＲ) 分别
在三阴乳腺癌和非三阴乳腺癌中的表达，分析其临床意义。方法: 选取三阴乳腺癌( Three negative breast cancer，
TNBC) 和非三阴乳腺癌( non－Three negative breast cancer，non－TNBC) 各50 例，免疫组化方法检测表皮生长因子
受体( EGFＲ) 、上皮性钙黏附蛋白( E－cadherin) 、雄激素受体( AＲ) 的表达情况，分析它们各自表达意义，与临床
因素和预后的关系。结果: ( 1) EGFＲ 在100 例乳腺癌中阳性率为48%( 48 /100) ，E－eadherin 异常表达率和AＲ
阳性率分别为53%( 53 /100) 、65%( 65 /100) 。( 2) E－cadherin 正常表达组和AＲ 阳性组的5 aDFS 分别高于Ecadherin
异常表达组和AＲ 阴性组( P＜0．05) ，差别有统计学意义。( 3) EGFＲ、E－cadherin、AＲ 在TNBC 和non－
NBC 中的表达情况: TNBC 中EGFＲ 阳性率和E－cadherin 异常表达率高于non－TNBC，AＲ 阳性率低于non－TNBC
( P＜0．05) ，差别有统计学意义。( 4) EGFＲ、E－cadherin、AＲ 在TNBC 中表达情况: TNBC 中，腋淋巴结阳性组的
AＲ 阳性率，EGFＲ 阳性率，E－cadherin 异常表达率高于腋淋巴结阴性组。结论: ( 1) TNBC 组织学分级较差，预后
较non－TNBC 差。( 2) TNBC 中，EGFＲ 的阳性表达，预示着病人预后差。腋淋巴结转越多，AＲ 的表达率越低。
( 3) 腋淋巴结是否转移可作为预测因素。( 4) EGFＲ 用于评价TNBC 的预后。( 5) AＲ 可能成为新靶点。

Objective: Using immunohistochemical method to explore the pathological
characteristics and prognosis of breast cancer three Yin type，detection of epidermal growth factor receptor(
EGFＲ) ，epithelial calcium adhesion protein－cadherin( E) and androgen receptor( AＲ) respectively
in three Yin three Yin expression in breast cancer，breast cancer and analyze its clinical significance．
Methods: Selecting three Yin breast cancer( TNBC) and Yin( non－TNBC) 50 cases of breast cancer，
immunohistochemical method to detect the epidermal growth factor receptor( EGFＲ) ，calcium epithelial
sex adhesion protein－cadherin( E) ， the expression of androgen receptor( AＲ) ，analysis their respective
meaning expression，and the relationship between clinical factor and prognosis．Ｒesults: ( 1) The positive
rate of EGFＲ in 100 cases of breast cancer was 48% ( 48 /100) ，and the expression rate and AＲ
positive rate were 53%( 53 /100) and 65%( 65 /100) respectively．( 2) The 5－year DFS of e－cadherin
normal expression group and AＲ positive group were higher than the e－cadherin abnormal expression
group and AＲ negative group( P＜0．05) ，and the difference was statistically significant．( 3) Expression
of EGFＲ，e－cadherin，AＲ in TNBC and non－nbc: the abnormal expression rate of EGFＲ and e－cadherin
in TNBC was higher than non－tnbc，and the positive rate of AＲ was lower than non－tnbc( P＜
0．05) ，and the difference was statistically significant．( 4) Expression of EGFＲ，e －cadherin and AＲ in
TNBC: in TNBC， the AＲ positive rate of the axillary lymph node positive group，EGFＲ positive rate，e －
cadherin abnormal expression rate was higher than the negative group of axillary lymph node．Conclusion:
( 1) TNBC histological classification is poor，and the prognosis is less than non － TNBC． ( 2)
Positive expression of EGFＲ in TNBC indicates poor prognosis．The more the axillary lymph nodes turn，
the lower the expression rate of AＲ． ( 3) Metastasis of axillary lymph nodes can be a predictor． ( 4)
EGFＲ is used to evaluate the prognosis of TNBC．( 5) AＲ may be a new target．

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 收稿日期: 2017－12－08; 修回日期: 2018－02－26
基金项目: 内蒙古自治区人民医院院内基金( 201312)
作者简介: 成绥生( 1962－) ，男，内蒙古自治区人民医院肿瘤外科主任医师。