新疆地区2001-2010年可手术女性乳腺癌患者临床病理特征及诊疗模式的演变:一项单中心研究

Trends of clinicopathological features and diagnosis and treatment methods for operative female patients with breast cancer in Xinjiang Uygur Autonomous Region:A single center study

目的：分析新疆地区2001—2010年可手术女性乳腺癌患者的临床病理特征和诊疗模式的演变趋势,为新疆地区乳腺癌防治工作提供临床依据。方法：采用系统随机抽样模式,回顾性分析新疆医科大学附属肿瘤医院2001—2010年1 024例可手术女性乳腺癌患者的临床病理资料和随访资料,对2001—2005年与2006—2010年的数据进行比较。结果：与2001—2005年相比,2006—2010年收治乳腺癌病例数增加215%。1 024例患者的平均发病年龄为47.80岁。2006—2010年早期乳腺癌（0~Ⅰ期）检出率（21.0%）较2001—2005年（16.2%）显著增加（P〈0.05）,而Ⅲ期乳腺癌占比显著下降（由30.6%降至19.0%）（P〈0.05）,原位癌占比则由3.2%上升至5.1%。2001—2005年腋窝淋巴结转移率为56.0%,2006—2010年下降至47.0%（P〈0.05）。局部复发/远处转移率亦呈下降趋势,2001—2005年和2006—2010年分别为29.0%和22.7%（P〈0.05）。术后5年总生存率和5年无病生存率分别由2001—2005年的79.7%和71.7%提高至2006—2010年的86.7%和77.3%（P值均〈0.05）。乳腺癌改良根治术始终是主要的手术方式,2001—2005年和2006—2010年分别为81.1%和87.3%;保乳术占比逐渐增加,由2001—2005年的3.1%上升至2006—2010年的9.1%。接受新辅助化疗、术前空心针穿刺活检、免疫组织化学检测和荧光原位杂交技术检测患者的比例均呈上升趋势（P值均〈0.05）。结论：2001—2010年,本院收治乳腺癌病例数显著增加。提高早期病例检出率以及规范化应用综合性诊疗措施是改善预后的关键。

Objective： To review the clinicopathological characteristics and diagnosis and treatment methods for operative female patients withbreast cancer admitted to Tumor Hospital affiliated to Xinjiang Medical University during 2001-2010, and provide the clinical evidence for prevention and control of breast cancer.Methods： One thousand and twenty-four operative female patients with breast cancer from Tumor Hospital affiliated to Xinjiang Medical University during 2001-2010 were selected by using random sampling. The clinical data and follow-up information of 1 024 patients were retrospectively analyzed, and the data between 2001-2005 and 2006-2010 were compared.Results： As compared with 2001-2005, the number of breast cancer patients during 2006-2010 was increased by 215%. The average age of onset in 1 024 patients was 47.80 years. The detection rate of early breast cancer （stages 0- 1） during 2006-2010 was significantly improved as compared with that during 2001-2005 （21.0% vs 16.2%, P 〈 0.05）, but the proportion of patients with stage IH breast cancer was obviously decreased （19.0% vs 30.6%, P 〈 0.05）; while the proportion of patients with breast cancer in situ was increased （5.1% vs 3.2%）. The rate of axillary lymph node metastasis during 2001-2005 was 56.0%, which decreased to 47.0% during 2006-2010 （P 〈 0.05）. The local recurrence/distant metastasis rate was 29.0%, which decreased to 22.7% during 2006-2010 （P 〈 0.05）. The postoperative 5-year survival rate and 5-year disease-free survival rate increased from 79.7% and 71.7% during 2001-2005 to 86.7% and 77.3% during 2006-2010, respectively （P 〈 0.05）. The main operation method for breast cancer was modified radical mastectomy （2001-2005： 81.1%; 2006-2010： 87.3%）. The proportion of breast-conserving surgery gradually increased from 3.1% during 2001-2005 to 9.1% during 2006-2010. The proportions of patients receiving neo-adjuvant chemotherapy, preoperative core needle biopsy, immunohistochemistry and fluorescence in situ hybridization also revealed an increasing trend （all P 〈 0.05）.Conclusion： The number of breast cancer patients admitted to Tumor Hospital affiliated to Xinjiang Medical University during 2001-2010 was in an increasing trend. It is important to improve the detection of early cases and use the standardized comprehensive diagnosis and treatment methods to improve the prognosis of patients.