乳腺导管原位癌患者生活质量调查及相关因素分析

Survey of quality of life for patients with breast ductal carcinoma in situ and analysis of related factors

目的调查乳腺导管原位癌（DCIS）患者生活质量（QOL），分析其相关影响因素。方法采用36条目简明量表（sF-36），对术后1年的84例DCIS患者、125例浸润性乳腺癌患者进行QOL评估，分析年龄、手术方式、内分泌治疗、学历、婚姻状况、工作状态、医疗保险对患者QOL的影响。结果与正常女性相比，术后1年的DCIS患者在生理功能（t=2．468，P=0．029）、躯体疼痛（t=2．076，P=0．039）、总体健康（t=2．153，P=0．033）和精神健康（t=3．396，P=0．003）4个维度得分较低，而浸润性乳腺癌患者在生理功能（t=5．638。P=0．002）、躯体疼痛（t=5．417，P=0．002）、活力（t：4．438，P=0．002）、总体健康（t=3．960，P=0．002）和精神健康（￡=6．020，P：0．001）5个维度得分低于正常。两组患者QOL大致相似，有6个维度得分差异无统计学意义，但在生理功能（t：2．714，P=0．032）和活力（t=2．134，P=0．040）方面DCIS患者优于浸润性癌患者。术后内分泌治疗是影响DCIS患者QOL的重要因素，显著降低了患者生理功能（t：2．082）、躯体疼痛（t=2．003）、总体健康（t=2．751）、活力（t=2．048）和精神健康（t=4．162）5个维度得分，P均小于0．05。结论术后1年DCIS患者QOL较差，内分泌治疗是重要影响因素。

Objective To study the quality of life （QOL） of patients with ductal carcinoma in situ （DCIS） and to analyze the relevant factors affecting their QOL. Methods A total of 84 patients with DCIS and 125 patients with invasive breast cancer were surveyed. Researchers used SF-36 to assess the QOL of participants at one year after operation. The relationships between some information of patients and SF-36 score were analyzed, such as age, the type of surgery, endocrine therapy, education, marital status, working status and health insurance. Results Compared to normal women, patients with DCIS had lower QOL in physical function （t = 2. 468, P = 0. 029）, bodily pain （t = 2. 076, P = 0. 039）, general health （t = 2. 153, P = 0. 033） and mental heahh （ t = 3. 396, P = 0. 003）. Patients with invasive breast cancer also had poorer QOL in physical function （ t = 5. 638, P = 0. 002 ）, bodily pain （ t = 5. 417, P = 0. 002 ）, vitality （ t = 4.438, P= 0.002） , general health （t =3.960, P =0.002） and mental health （t =6.020, P =0.001）. QOL of DCIS patients was similar to that of invasivc breast cancer patients, except that scores of physical function （ t = 2.714, P = 0.032 ） anti vitality （ t = 2.134, P = 0. 040） were better in DCIS patients. Endocrine therapy significantly affected the score of QOL of DCIS patients. DCIS patients with endocrine therapy had poorer score in physical function （ t = 2. 082, P 〈 0.05 ） , bodily pain （ t = 2. 003, P 〈 0.05）, general health （t = 2. 751, P 〈 0.05）, vitality （t =2.048, P〈0.05） and mental health （t =4. 162, P〈0.05）. Conclusion Patients with DC1S hav poor QOI, at one year after operation. Endocrine therapy significantly reduces their QOL.