110例乳腺癌脑转移临床特点及预后因素分析

Clinical Features and Prognostic Factors for 110 Cases of Breast Cancer with Brain Metastasis

[目的]探讨乳腺癌脑转移患者的临床病理特征及影响其预后的相关因素。[方法]分析110例乳腺癌脑转移病例的年龄、TNM分期、病理类型、组织学分级、ER/PR/HER-2表达情况、绝经状况、第一转移灶位置,以及脑转移时颅内转移灶数目,并统计1年生存率。[结果]浸润性导管癌为最常见的病理类型,组织学分级均为2/3级,单发颅内转移灶的比例为29.1%。1年生存率为33.6%,其中年龄<50岁组的1年生存率为42.6%,≥50岁组为22.4%(P=0.026);ER阳性患者的1年生存率为47.2%,高于ER阴性患者的26.3%(P=0.039),颅内转移灶单发患者的1年生存率达53.1%,明显高于多发转移灶患者的25.6%(P=0.006)。[结论]首次确诊乳腺癌时的年龄、ER表达状况、颅内转移灶数量是影响乳腺癌脑转移患者预后的独立因素。

[Purpose] To investigate the clinical features and prognostic factors of breast cancer with brain metastasis. [Methods] The clinical data of 110 breast cancer patients with brain metastasis including age, TNM stage, pathological type, histological grade, ER/PR/HER-2 status, menopausal status and first metastatic site, the number of brain metastasis at diagnosis of brain metastasis were analyzed. One-year survival was analyzed. [Results] The median age at diagnosis of breast cancer was 46 years old, the most common pathological type was invasive ductal carcinoma, histological grade was grade 2 or 3 for all. Single brain metastasis account for 29.1%. One year survival was 33.6%. One year survival in patient aged50 years, ER-positive or single brain metastases was higher than that in patient aged≥50 years （42.6% vs 22.4%, P=0.026）, ER-negative （47.2% vs 26.3%, P=0.039） and multiple brain metastases （53.1% vs 25.6%, P=0.006）. [Conclusion] Age at initial diagnosis ER status and the number of brain metastasis are independent prognostic factors of breast cancer patients.