摘要
目的 通过回顾性分析早期乳腺癌术后胸壁复发患者的病例资料,探讨早期乳腺癌患者术后胸壁复发的相关因素。方法 选取2008-2009年该院收治的共130例早期乳腺癌术后胸壁复发患者的临床、病理及预后资料,分析其临床特点、胸壁复发时间,Kaplan-Meier法、雌激素受体法计算患者无瘤生存率,COX模型行多因素分析。结果 3、5年无瘤生存率分别为58.4%和33.7%,3、5年总体生存率为91.4%和83.9%,中位发病年龄为45岁,中位复发时间为25个月,中位生存时间为56个月。预后相关因素的COX分析显示,肿瘤分期、肿瘤细胞分化程度、淋巴结转移、C雌激素受体B-2表达、雌激素受体、孕激素受体及Ki-67表达是影响患者5年总体生存率的因素（=0.006、0.015、0.008、0.005、0.024、0.019和0.028）。结论 肿瘤分期晚、肿瘤细胞分化程度低、存在淋巴结转移、C雌激素受体B-2阳性表达、雌激素受体和孕激素受体低表达及Ki-67高表达是影响患者5年总体生存率的相关因素,对存在上述危险因素的患者,应根据患者情况选择个体化治疗方案,改善患者预后。
Objective To retrospectively analyze the data of the cases of early-stage breast cancer with chest wall recurrence after masteetomy, and to analyze the factors correlated to their prognosis. Methods The clinical, pathological and prognostic data of 130 cases with chest wall recurrence after mastectomy for early- stage breast cancer from 2008 to 2009 in this hospital were analyzed and the clinical features were observed during follow-up. The disease-free survival rate was analyzed by Kaplan-Meier method and the multivariate analysis was executed by COX model. Results The 3- and 5-year disease-free survival rates of these patients were 58.4% and 33.7%, respectively. The 3- and 5-year overall survival rates of these patients were 91.4% and 83.9%, respectively. Median age was 45 years. The median recurrence time was 25 months and the median survival time was 56 months. COX regression analysis showed that tumor stage, tumor differentiation, lymph node metastasis, the expressions of CerbB-2, ER, PR and Ki-67 were the factors that affected the overall 5-year survival rate of the patients with chest wall recurrence after mastectomy for early-stage breast cancer （P= 0.006, 0.015, 0.008, 0.005, 0.024, 0.019 and 0.028 respectively）. Conclusions In the early breast cancer patients with chest wall recurrence after mastectomy, late tumor stage, poor differentiation, lymph node metastasis, positive CerbB-2 expression, high expression of Ki-67, and low expressions of ER and PR are the factors affecting the overall 5-year survival rate. Thus for the patients with such risk factors, individualized treatment programs should be chosen according to the actual situation to improve prognosis.
出处
《中国现代医学杂志》
CAS
北大核心
2016年第21期131-135,共5页
China Journal of Modern Medicine
关键词
乳腺癌
胸壁复发
预后
因素分析
breast cancer
chest wall recurrence
prognosis
factor analysis
