晚期乳腺癌脑转移危险因素分析

Risk Factors for Brain Metastases from Advanced Breast Cancer

目的分析晚期乳腺癌脑转移危险因素,指导临床筛选脑转移高危患者。方法应用卡方检验及t检验进行单变量分析,对筛选出的脑转移危险因素进行多变量Logistic回归分析。结果单变量分析显示,肿瘤最长径、阳性淋巴结数目、分子分型、人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)、辅助化疗、无病生存时间、肺转移、局部复发、淋巴结转移9项因素有统计学意义(P<0.05)。多变量Logistic回归分析显示,术后辅助化疗不标准(P<0.001)、存在肺转移(P=0.003)及HER2阳性(P=0.003)为晚期乳腺癌脑转移的高危因素;所得Logistic回归方程对脑转移的预测正确率为73.9%。结论晚期乳腺癌脑转移高危因素为术后辅助化疗不标准、存在肺转移及HER2阳性。

Objective To analyze the risk factors for brain metastasis from advanced breast cancer and provide clinical guide to screen high risk patients for brain metastasis. Methods T test and Chi-square Test were used for univariate analysis to find out the risk factors for brain metastasis, and these factors were analyzed by multivariable logistic regression analysis. Results Univariate analysis showed that 9 risk factors, such as tumor diameter, number of involved positive lymph nodes, molecular typing, HER2, adjuvant chemotherapy, disease-free survival, lung metastasis, local recurrence and lymph node metastasis, were statistically significant for brain metastasis(P<0.05). Multivariable logistic regression analysis showed nonstandard adjuvant chemotherapy(P<0.001), lung metastasis(P=0.003) and HER2 positive(P=0.003) were high risk factors for brain metastasis from advanced breast cancer. The accuracy of prediction based on logistic regress equation for the brain metastases was 73.9%. Conclusion Risk factors for brain metastasis from advanced breast cancer are nonstandard adjuvant chemotherapy, lung metastasis and HER2 positive.