乳腺癌家族史对乳腺癌临床特点及预后的影响

Impact of family history on clinical characteristics and prognosis in patients with breast cancer

目的：探讨乳腺癌家族史对乳腺癌患者的临床生物学特性以及预后的影响。方法：回顾性分析天津医科大学附属肿瘤医院乳腺科1989年8月1日～1994年6月30日收治的1999例乳腺癌患者的临床资料。其中乳腺癌家族史阳性（FHP）患者87例，无乳腺癌家族史（FHN）患者1912例，比较分析两组临床病例资料及预后情况。结果：FHP组临床分期旱于FHN组，两者差异有统计学意义，χ^2=7．206，P=0．027；FHP组腋淋巴结转移率（37．2％）低于FHN组（50．2％），差异有统计学意义，χ^2=5．585，P=0．018。而在发病年龄、绝经状态、肿瘤大小、病理类型、雌孕激素受体（ER／PR）状况、术后3年局部复发率和远处转移率方面，两组比较，差异均无统计学意义（1。值分别为2．088、1．290、1．653、2．202、0．270、0．026和1．804；P值分别为0．554、0．256、0．438、0．532、0．603、0．872和0．179）。Kaplan-Meier生存分析显示，FHP组总体5、10年生存率（分别为89．63％和79．12％）有高于FHN组（分别为81．53％和73．77％）的趋势，但差异无统计学意义，log—rank值=1．260。P=0．262。结论：我们的研究并未发现乳腺癌家族史对预后的影响有统计学意义，同时我们的研究结果提示，只要充分认识FHP乳腺癌的特点，积极诊断治疗，其预后和散发性乳腺癌差异无统计学意义，但还需要进一步研究证实。

OBJECTIVE： To explore the clinical features and prognosis of hreast cancer patients with positive family history. METHODS： Data of 1 999 breast cancer patients admitted in Tianiin Cancer Hospital from August 1st 1989 to June 30th 1994 were analyzed retrospectively. The clinical data of the two groups were compared. RESULTS： Clinical stage of Group FHP was significantly earlier than that of Group FHN （χ^2 =7. 206 ,P=0. 027）, and the incidence rate of metastasis of lymph node in Group FHP（37.2%） was significantly lower than that of Group FHN（50.2%）,χ^2 = 5. 585 ,P=0. 018. However, the differences had no statistical significance in age, menopause status） tumor size, pathologic type, estrogen receptors （ER） or progestogen receptors （PR） status） local recurrence and systematic metastasis 3 years after operation （respectively, χ^2 = 2. 088, 1. 290. 1. 653, 2. 202, 0. 270, 0. 026, 1. 804, and respectively, P = 0. 554, 0.256, 0.438, 0.532, 0.603, 0.872,0.179, . Overall 5-year and 10-year survival rates in Group FHP（89.63%, 79.12%）, as compared with those of Group FHN （81.53%, 73. 77%）, had no significant difference between the both groups, log-rank = 1. 260, P = 0. 262. CONCLUSIONS, This study does not find that positive family history is statistically associated with clinical prognosis in the study population. It suggests that FHP patients would he obtained efficiency similar to FHN patients, if prompt measures has been taken. Further research is needed to verify this finding.