乳腺癌治疗后妊娠对预后影响探讨

Influence of pregnancy on the prognosis of breast cancer after treatment

目的探讨乳腺癌治疗后妊娠对预后影响。方法选择2005年1月至2010年5月在本院行乳腺癌治疗后妊娠的20例乳腺癌患者作为观察组,另选择同期行乳腺癌治疗后无生育的20例乳腺癌患者作为对照组。两组患者均行病理学检查为乳腺癌,无远处转移,且行手术及化疗治疗。治疗后,常规随访5年以上,记录观察组患者的妊娠情况、新生儿Apgar评分、婴儿生长发育情况,比较两组患者5年无病生存率和5年总生存率。结果观察组20例患者中,15例患者均妊娠≥38周,足月分娩;不良妊娠结局发生率为25.00%;17例新生儿Apgar评分为9~10分。观察组复发率、远处转移率均低于对照组,差异具有统计学意义(P<0.05);观察组5年无病生存率显著高于对照组,差异具有统计学意义(P<0.05);两组患者的死亡率和5年总生存率比较,差异不具有统计学意义(P>0.05)。结论乳腺癌治疗后妊娠对预后具有一定积极影响,可预防复发及远处转移,有助于患者生存时间延长。

Objective To investigate the influence of pregnancy on the prognosis of breast cancer after treatment.Methods Twenty cases of breast cancer patients with pregnancy in our hospital after breast cancer treatment from January 2005 to May 2010 were selected as observation group, and twenty cases of breast cancer patients with no other family underwent breast cancer after treatment were selected as control group. Patients in the two groups were diagnosed as breast cancer by pathological examination with no distant metastasis and treated with surgery and chemotherapy. After treatment, routine follow-up for more 5 years, the pregnancy, neonatal Apgar score, growth and development of infants in the observation group were recorded, and the 5 years disease-free survival rate and 5 years overall survival rate between the two groups were observed. Results In the observation group with 20 cases, 15 cases were pregnated more than 38 weeks and full-term delivery, and the incidence of adverse pregnancy outcomes was 25.00%, 17 cases of neonatal Apgar score was 9-10. The recurrence rate, distant metastasis rate of the observation group were lower than those of the control group, the differences were statistically significant（P〈0.05）; the 5 years disease-free survival rate was significantly higher than that of the control group, the difference was statistically significant（P0.05）; the mortality and 5 year overall survival rate comparison between the two groups had no significant differences（ P〈0.05）. Conclusion Pregnancy after treatment of breast cancer has a positive impact on the prognosis, which can prevent recurrence and distant metastasis,help to prolong the survival time of patients.