目的    探讨c-myc蛋白在三阴性乳腺癌（triple negative breast carcinoma，TNBC）中的表达情况及其与术后复发转移的关系。方法    对2005年1月至2008年4月在福建医科大学附属第二医院（98例）及新疆维吾尔族自治区昌吉回族自治州人民医院（59例）接受手术治疗的157例女性TNBC病人与同期30例（两院分别为20例、10例）非TNBC病人，20例（两院各10例）正常乳腺石蜡组织标本就c-myc表达情况进行回顾性分析。结果    c-myc在TNBC中表达阳性率，高于非TNBC及正常乳腺，差异具有统计学意义（P＜0.05）。单因素分析显示TNM分期、组织学分级、腋窝淋巴结转移、术后复发转移是c-myc表达的相关因素（P＜0.05）；Logistic回归显示TNM分期不是c-myc表达的影响因素（OR=2.243，P=0.073）。影响无病生存时间的单因素分析显示，年龄、临床分期、组织学分级、腋淋巴结转移及c-myc的表达与TNBC复发转移有关（P＜0.05）；Cox模型分析显示，临床分期与c-myc的表达被剔除。结论    c-myc可能是影响TNBC术后复发转移的因素，但并不是独立危险因素。c-myc表达可以作为TNBC病程进展和恶性程度判定的指标之一。

Expression of c-myc in triple negative breast cancer and its relationship with recurrence and metastasis                      ZENG Jian-feng*, QIU Cheng-zhi, ZHOU Zhi-ping, et al. *Department of General Surgery, the Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000,China
Corresponding author: ZENG Jian-feng, E-mail: bbjian@gmail.com
Abstract    Objective    To explore the c-myc protein expression in triple negative breast cancer and its relationship with recurrence and metastasis. Methods    C-myc expression of 157 cases of women TNBC underwent surgery, 30 cases of non-TNBC and 20 cases of normal breast tissue paraffin samples admitted between January 2005 and April 2008 in the Second Affiliated Hospital of Fujian Medical University（98 cases of TNBC, 20 cases of non-TNBC and 10 cases of normal samples） and Changji Hui Autonomous Prefecture People's Hospital of Xinjiang Uygur Autonomous Region（59 cases of TNBC, 10 cases of non-TNBC and 10 cases of normal samples） were analyzed retrospectively. Results    Positive rate of c-myc expression in TNBC was higher than that of non-TNBC and that of normal breast with significant difference (P＜0.005). Univariate analysis showed that TNM stage, histological grade, axillary lymph node metastasis, postoperative recurrence and metastasis were the related factors of c-myc expression (P＜0.05). Logistic regression analysis showed that TNM staging was not the influential factors of c-myc expression （OR=2.243，P=0.073）. Univariate analysis of affected disease-free survival time showed that age, clinical stage, histological grade, axillary lymph node metastasis and c-myc expression had relationship with recurrence and metastasis of TNBC (P＜0.05). Multivariate clinical staging and c-myc expression were excluded. Conclusion    C-myc may be an influential factor of postoperative recurrence and metastasis of triple negative breast cancer, but be not an independent risk factor. C-myc expression can be used as one of indicators of progression and malignant degree of TNBC.