影响乳腺癌术后化疗联合放疗患者远期预后的相关因素分析

Factors associated with the long-term prognosis of chemotherapy combined with radiotherapy after surgery for breast cancer

目的研究影响乳腺癌术后化疗联合放疗患者远期预后的相关因素。方法选取成都医学院第一附属医院2012年1月至2015年1月行乳腺癌根治术患者,共174例,术后均接受化疗联合放疗。收集年龄、月经状态、肿瘤直径、淋巴结状态、肿瘤部位、病理类型、癌症家族史、雌激素受体、孕激素受体、原癌基因人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)表达等临床及病理资料。所有患者均接受为期3年随访,以患者肿瘤复发或死亡为终点。无病生存期≤3年患者纳入预后不良组,无病生存期>3年患者纳入预后良好组,比较2组临床及病理资料。结果 174例患者有效随访人数166例,其中复发24例,死亡6例,预后不良率为18.1%。预后良好组年龄>40岁、肿瘤直径<2 cm、无淋巴结转移、非浸润性癌、雌激素受体阳性、孕激素受体阳性、HER2阴性患者比例显著高于预后不良组(P<0.05)。结论年龄、肿瘤直径、淋巴结状态、病理类型、雌激素受体、孕激素受体、HER2表达情况等7个因素对乳腺癌患者预后有显著影响。

Objective To study the related factors influencing the long-term prognosis of chemotherapy combined with radiotherapy after surgery for breast cancer. Methods One hundred and seventy-four patients who underwent radical mastectomy in the hospital from January 2012 to January 2015 were selected. All of them were treated by chemotherapy combined with radiotherapy after surgery. The clinicopathological data of patients such as age,menstrual status,tumor diameter,lymph node status,tumor location,pathological type,family history of cancer,estrogen receptor,progesterone receptor and expression of proto-oncogene human epidermal growth factor receptor 2（ HER2） were collected. All patients were followed up for 3 years. The patients were grouped with tumor recurrence or death as the endpoint. Patients with disease-free survival（ DFS） ≤3 years were included in the poor prognosis group,and patients with DFS〉 3 years were included in the good prognosis group. The clinicopathological data were compared between the two groups. Results In174 patients,166 cases were followed up effectively,including 24 cases with recurrence and 6 death cases. The rate of poor prognosis was 18. 1%. The proportions of patients older than 40 years old,with tumor diameter shorter than 2 cm,without lymph node metastasis,with non-invasive cancer,estrogen receptor positive,progesterone receptor positive and HER2 negative patients in the good prognosis group were significantly higher than those in the poor prognosis group（ P〈0. 05）. Conclusion Age,tumor diameter,lymph node status,pathological type,estrogen receptor,progesterone receptor and expression of HER2 have significantin fluence on the prognosis of patients with breast cancer.