中晚期乳腺癌脑转移患者的危险因素分析

Analysis of risk factors of patients with advanced breast cancer brain metastasis

目的:探讨中晚期乳腺癌患者发生脑转移的危险因素。方法:回顾性分析2004年8月-2014年8月期间来我院治疗的中晚期乳腺癌患者的临床资料。根据是否发生脑转移将患者分为实验组和对照组,实验组由发生脑转移的80例患者组成,对照组由未发生脑转移的100例患者组成。采用Logistic逐步回归分析,分析中晚期乳腺癌患者发生脑转移的危险因素。结果:两组患者PR状况、绝经状况以及临床分期等差异不具有统计学意义(P>0.05)。两组患者的年龄、KPS评分、ER状况、HER-2状况、肿瘤直径大小以及组织学分级等临床资料差异较大,具有统计学意义(P<0.05)。经Logistic回归逐步分析可知,组织学分级(Ⅲ级)的优势比最高(Wald=11.486),是影响患者发生脑转移的最危险因素,其次是肿瘤直径大小(≥5cm)(Wald=10.654)、ER状况(阴性)(Wald=9.123),年龄(<55岁)影响最小(Wald=6.085)。结论:中晚期乳腺癌患者发生脑转移的因素较多,如年龄、KPS评分、ER状况、HER-2状况、肿瘤直径大小以及组织学分级等,治疗过程中,应加以重视,以降低患者转移率。

Objective：To explore the risk factors of patients with advanced breast cancer brain metastases.Methods：To retrospectively analyze the data of 180 patients with advanced breast cancer.All patients were divided into experimental group and control group.Patients in experimental group were 80 cases with brain metastases,control group consisted of 100 patients without brain metastases.Logistic regression analysis was used to study the risk factors of brain metastases.Results：In two groups,PR status,menopausal status and clinical staging were not statistically different（ P〉0.05）.Patients age,KPS score,ER status,HER-2 status,tumor diameter and histological grading were different statistically（ P〈0.05）.Logistic regression analysis showed progressively dominant histological grading（ Ⅲ）ratio was 11.486,tumor diameter（ ≥5cm）（ Wald = 10.654）,ER status（ negative）（ Wald = 9.123）,age（ 55 years old）（ Wald = 6.085）.Conclusion：Risk factors of advanced breast cancer patients with brain metastases were age,KPS score,ER status,HER-2 status,tumor diameter and histological grade.