147例晚期乳腺癌首次转移部位及其预后影响因素分析

Analysis of the first metastasis pattern and prognostic factors of 147 patients with metastatic breast cancer

目的探讨晚期乳腺癌患者首次转移部位及其预后影响因素。方法选取2016年6月至2018年6月期间在武汉大学人民医院乳腺甲状腺中心及肿瘤科首次明确诊断的晚期乳腺癌患者147例,对其首次转移的部位、方式及可能影响其预后的首次确诊乳腺癌时的年龄、肿瘤大小、淋巴结转移数目、激素受体情况、HER-2状态、转移器官及数目、肿瘤原发部位、分子分型等进行回顾性分析。结果骨是乳腺癌最常见的转移部位,有55例(37.41%);其次为肺和肝,分别为29例(19.73%)和24例(16.33%)。单因素分析结果显示,淋巴结转移数目、HER-2状态、首次转移器官数目及术后是否进行内分泌治疗是影响患者生存时间的因素(P<0.05)。多因素分析结果显示,淋巴结转移数目、转移器官数目及HER-2状态是影响晚期乳腺癌预后的独立危险因素(P<0.05)。结论乳腺癌患者术后最常见的转移部位为骨,其次为肺和肝。淋巴结转移数目、转移器官数目、HER-2状态以及术后治疗方式是影响晚期乳腺癌患者预后的独立因素。

Objective To study on the first metastasis pattern and prognostic factors in patients with recurrent and metastatic breast cancer.Methods The study selected 147 patients with metastatic breast cancer who were diagnosed for the first time in the Breast Thyroid Center and Oncology Department,the People’s Hospital of Wuhan University from June 2016 to June 2018.The model of first metastasis and the first diagnosis of prognosis may be affected.The age at diagnosis of breast cancer,tumor size,lymph node metastasis,hormone receptor status,HER-2 status,number of metastatic organs,tumor location,molecular typing,etc.were retrospective analyzed Results The most common metastatic sites for breast cancer was bone metastases in 55 patients(37.41%),followed by lung metastasis and liver metastases,29(19.73%)and 24(16.33%),respectively.Univariate analysis showed that the number of lymph node metastasis,HER-2 status,organ number of first-time metastasis,and endocrine therapy were significant factors affecting metastatic survival time,and the difference was statistically significant(P<0.05).Multivariate analysis showed that the number of lymph node metastasis,the number of metastatic organs and HER-2 were independent risk factors for advanced breast cancer(P<0.05).Conclusions The most common metastasis of breast cancer patients after surgery is bone,followed by lung metastasis and liver metastasis.The number of lymph node metastases,the number of metastatic organs,HER-2 status,and endocrine therapy are independent factors influencing the prognosis of patients with recurrent metastasis.