乳腺癌患者的临床特征及其辅助治疗的影响因素分析

Analysis of Clinical Pathological Characteristics and Auxiliary Treatment Factors of Breast Cancer

目的：探讨乳腺癌患者的临床病理特点及其辅助治疗的影响因素。方法：选取2009年1月~2012年2月我院收治的114例60岁以上的乳腺癌患者,按照年龄将其分为60~69岁组以及70岁以上组,对两组患者的临床特点、病例特点以及辅助治疗的模式进行对比分析。结果：两组患者在合并疾病、癌肿大小、病理学类型、受累淋巴结、以及雌孕激素受体阳性率、表皮生长因子2过度表达、肿瘤抑制基因P53阳性率以及Ki-67增殖指数等方面相比较,差异均无统计学意义（P〉0.05）。两组患者的手术治疗方式以及术后辅助化疗情况相比较,差异有统计学意义（P〈0.05）。多因素Logistic回归分析发现,年龄、淋巴结受累情况以及雌激素受体是否阳性成为术后辅助化疗主要考虑的因素。随诊2年,60~69岁组与70岁以上组患者的2年无复发生存率分别为88.89%（64/72）、92.86%（39/42）,两组相比较,差异无统计学意义（P〉0.05）。结论：70岁以上的乳腺癌患者的临床特点与60~69岁的患者相比较无明显差异,目前,临床治疗采取的方法有所不同,但均能够达到较好的效果。年龄、淋巴结受累情况以及雌激素受体是否阳性成为医生考虑术后辅助化疗方案的主要因素。

Objective： To investigate the clinical pathological characteristics and auxiliary treatment factors of breast cancer.Methods： 114 cases of breast cancer patients over the age of 60 from January 2009 to February 2012 in our hospital were divided into the60 to 69 years old group and over 70 years old group according to the age, clinical features, case characteristics and mode of adjuvant therapy were analyzed between the two groups. Results： The differences in complications, tumor size, pathological type, lymph node involvement, and estrogen and progesterone receptor-positive rate, over-expression of epidermal growth factor 2, the positive rate of tumor suppression gene P53 and proliferation index of Ki-67 between the two groups were not statistically significant（P0.05）. The differences of surgical treatment and postoperative adjuvant chemotherapy between two groups were statistically significant（P0.05）.Logistic regression analysis showed that age, lymph node involvement, and whether estrogen receptor was positive presented to be major factors to consider for adjuvant chemotherapy. Following up for 2 years, recurrence-free survival rates during the 2 years for 60 to 69 age group and over 70 age group patients were 88.89%（64/72） and 92.86%（39/42） respectively, with no statistically significant difference（P0.05）. Conclusion： There was no significant difference in the clinical features of breast cancer patients between age group of over 70 and the group of 60 to 69 years. At present, although clinical treatments methods are different, good results have been presented. Age,estrogen receptor-positiveness and lymph node involvement becomes the main factors considered for an adjuvant chemotherapy.