摘要
目的探讨乳腺癌术后局部复发的影响因素.方法自1997年1月至2001年1月我院共收治乳腺癌435例.回顾分析术后局部复发的肿瘤自身因素和治疗因素.结果 3年复发率6.4%(26/435),总复发率7.0%(29/435).肿瘤自身因素中,患者年龄、是否绝经、病理类型、激素受体情况、原发肿瘤大小和腋窝淋巴结转移数目是术后局部复发的主要影响因素,其中年龄≤35岁、36～59岁和≥60岁者局部复发率分别为8.1%、6.4%和5.8%(P<0.05);绝经前和绝经后患者局部复发率分别为8.8%和3.5%(P<0.05);各病理类型的局部复发率分别为:原位癌0,早期浸润癌2.0%,浸润性特异型癌4.0%,浸润性非特异型癌8.0%(P<0.05).原发肿瘤T1+T2局部复发率为4.4%,T3+T4为14.5%(P<0.01);腋下淋巴结N0局部复发率为3.0%,N1 8.3%,N2 13.0%(P<0.05);而患者性别和是否有肿瘤家族史对术后局部复发无显著影响.治疗因素中,术后辅助放疗对减少局部复发有一定作用(术后辅助放疗者局部复发率3.0%,未行术后放疗者13.0%,P<0.01);而保乳术后局部复发率(14.0%)高于根治术(3.0%)和改良根治术(7.0%,P<0.05).结论早期诊断、早期治疗是减少乳腺癌复发转移的有效途径,加强辅助治疗可以减少和延缓术后局部复发.
Objective To evaluate the main determinants of local rereurrence of breast cancer. Methods From Jan. 1997 to Jan. 2001,435 patiants with primary breast cancer were treated in this hospital. The risk factors related to postoperative local recurrence of the tumors and the treatment methods were analyzed retrospeetively. Results The rate of recurrence in 3 year was 6.4% （26/435） and the total rate of recurrence was 7.0% （ 29/435 ）. The age of patient, the status of menses,pathologic type, the status of estrogen receptor,tumor size, axillary nodal involvement were the main risk factors of postoperative local recurrence. The rates of recurrence in age≤35 year,36-59 year and ≥60 year were 8. 1% ,6.4% and 5.8% ,respectively,P 〈0.05. The rates of recurrence of premenopause and postmenopause were 8.8% and 3.5% , respectively,P 〈 0.05. In regard to pathologic types, the rates of recurrence in carcinoma in situ, early infiltrative carcinoma, infiltrative specific carcinoma and infiltrative non-speelfic carcinoma were 0,2.0%, 4. 0% and 8.0% , respectively,P 〈 0.05. In regard to tumor size, the rates of recurrence of T1 ＋ T2 and T3 ＋ T4 were 4.4% and 14.5% ,respectively,P 〈0.01. In regard to axillary nodal involvement, the rates of recurrence of N0, N1 and N2 were 3.0% , 8.3% and 13.0% , respectively,P 〈0.05. While sex and tumor family history of the patients were not significantly related to local recurrence. In treatment, postoperative radiotherapy could reduce the rates of recurrence （3.0% in the patients with postoperative radiotherapy, 13.0% in the patients without postoperative radiotherapy, P 〈 0.01 ）. The rate of recurrenee of breast-conserving treatment （ 14.0% ） was higher than that of radical operation （ 3. 0% ） and modified radical operation （7.0%）. Conclusions Early diagnosis and therapy will efficiently decrease the rate of local recurrence of breast cancer. Meanwhile, strengthening of adjuvant therapy can lower and postpone occurrence of postoperative local recurrence.
出处
《中国肿瘤临床与康复》
2005年第6期540-542,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
乳腺肿瘤
局部复发
因素
Breast neoplasms
Recurrence
Factor
