205例初治转移性乳腺癌的临床病理特点和生存分析

Clinicopathologic features and prognostic factors of 205 patients with pretreated metastatic breast cancer

目的：探讨转移性乳腺癌（metastatic breast cancer，MBC）的临床病理特征及生存预后。方法：收集2008年1月至2010年12月天津医科大学肿瘤医院205例乳腺癌根治术后出现复发及转移的初治患者的临床资料，对其临床病理特征及生存情况进行回顾性分析。结果：205例初治MBC患者的中位生存期为32（1～132）个月，分子分型为Luminal A、Luminal B、HER-2过表达型和三阴型乳腺癌，其中位生存期分别为36（4～132）、32（7～122）、29（1～85）和24（1～98）个月。单因素和多因素分析显示，淋巴结转移、临床分期、分子分型、内脏转移、首发转移部位数目均与转移性乳腺癌患者的预后有关（P〈0.05）。淋巴结转移、临床分期、分子分型及内脏转移是影响转移性乳腺癌患者预后的独立因素（P〈0.05）。结论：淋巴结转移、临床分期、三阴型乳腺癌及内脏转移是影响不良预后的独立因素，对判断预后和制定个体化治疗提供了重要依据，并对今后临床工作的开展具有指导意义。

Objective：To analyze the prognostic factors in patients with metastatic breast cancer （MBC）. Methods：A total of 205 patients with pretreated MBC were included in this study. These patients were admitted to the Tianjin Medical University Cancer Insti-tute＆amp;Hospital and had undergone radical surgery of breast cancer between January 2008 and December 2010. The clinicopathologic information of the patients was collected in this retrospective analysis. Results： The median overall survival of the patients was 32 months （1 month to 132 months）. Luminal A, Luminal B, HER-2 overexpression, and triple-negative patients had a median overall sur-vival of 36 months （4 months to 132 months）, 32 months （7 months to 122 months）, 29 months （1 month to 85 months）, and 24 months （1 month to 98 months）, respectively. Univariate analysis showed that lymph node metastases, clinical stage, molecular type, visceral disease, first multiple metastatic sites, and shorter metastasis-free interval were significantly associated with poor outcomes. In multivar-iate analysis, lymph node metastases, clinical stage, molecular type, visceral metastasis, and the number of first metastatic sites were significant predictors of patient survival. Conclusion：Lymph node metastasis, clinical stage, triple-negative breast cancer, and visceral metastasis were used as independent poor prognostic indicators for survival in patients. Results of this study may assist physicians in evaluating the survival potential and determining the appropriate therapeutic strategy for MBC patients.