乳腺癌同时合并原发性肺癌患者临床病理特征及预后影响因素

Clinicopathological features and prognostic factors of patients with breast cancer combined with primary lung cancer

目的探究乳腺癌合并原发性肺癌患者的临床病理特征和预后,为乳腺癌同时合并原发性肺癌患者的诊断及鉴别诊断提供帮助。方法回顾性分析了2009年9月至2021年1月于河北医科大学第四医院行进行治疗的乳腺癌患者临床病理资料(双原发组及乳腺癌组),并进行差异分析。使用Kaplan-Meier方法绘制生存曲线,并应用单多因素Logistic回归分析探究乳腺癌患者发生肺癌的危险或保护因素。使用单多因素Cox回归分析探究影响患者总生存期的危险或保护因素。结果使用倾向匹配得分(PSM)方法对2组患者进行匹配,纳入双原发组患者40例,乳腺癌组患者100例。差异分析表明,2组患者在雌激素受体(ER)表达、孕激素受体(PR)表达、人表皮生长因子受体-2(HER2)表达、Ki67表达方面具有统计学差异(P<0.05)。单多因素Logistic回归分析表明,PR表达阴性、HER2表达阴性、Ki67低表达是乳腺癌患者发生肺癌的独立危险因素(P<0.05)。生存曲线表明,双原发组患者的总生存期短于乳腺癌组。多因素Cox分析则表明,肿瘤分级是影响患者总生存期的独立保护因素(P<0.05)。结论PR阴性、HER2阴性、Ki67低表达的患者,伴发原发性肺癌的概率更高。N分期、M分期、肿瘤分期、肿瘤分级、ER表达阴性是影响这些患者总生存期的危险因素。上述因素可能在乳腺癌、肺癌双原发癌中具有重要作用。

Objective To explore the clinicopathological features and prognosis of breast cancer patients with primary lung cancer,in order to provide help for the diagnosis and differential diagnosis of such patients.Methods The clinicopathological data of breast cancer patients with or without primary lung cancer(double primary cancer group and breast cancer group)treated at the Fourth Hospital of Hebei Medical University from September 2009 to January 2021 were retrospectively analyzed,and differences were analyzed.Survival curves were drawn using the Kaplan-Meier method,and single-multivariate logistic regression analysis was used to explore the risk or protective factors for lung cancer in breast cancer patients.Single and multivariate Cox regression analyses were used to explore the risk or protective factors affecting the overall survival of patients.Results The two groups of patients were matched using the propensity score matching method,including 40 patients in the double primary cancer group and 100 patients in the breast cancer group.There were significant differences in estrogen receptor(ER)expression,progesterone receptor(PR)expression,human epidermal growth factor receptor 2(HER2)expression,and Ki67 expression between the two groups(P<0.05).Single multivariate Logistic regression analysis showed that PR negativity,HER2 negativity,and low Ki67 expression were independent risk factors for lung cancer in breast cancer patients(P<0.05).Survival curve analysis demonstrated that the overall survival of patients in the double primary cancer group was shorter than that of the breast cancer group.Multivariate Cox analysis demonstrated that tumor grade was an independent protective factor for the overall survival of patients(P<0.05).Conclusion Breast cancer patients with PR-negative,HER2-negative,and low Ki67 expression have a higher probability of developing primary lung cancer.N stage,M stage,tumor stage,tumor grade,and ER negativity are risk factors affecting the overall survival of these patients.The above factors may play an important role in the dual primary breast cancer and lung cancer.