208例T1-2N1M0期乳腺癌改良根治术患者无病生存情况的危险因素分析

Risk factors analysis of Disease-Free Survival after modified radical mastectomy in 208 patients with T1-2N1M0 breast cancer

目的探究行改良根治术的T1-2N1M0期乳腺癌患者无病生存的影响因素。方法回顾性分析2011年1月至2014年11月经改良根治术治疗208例T1-2N1M0期乳腺癌患者资料,统计术后截止2019年11月患者随访情况,并记录患者术后5年肿瘤转移、复发情况,以SPSS 22.00统计学软件进行数据处理。计数资料用[例(%)]表示,组间比较采用χ^2检验;乳腺癌患者预后的相关因素行单因素和Cox多因素回归模型分析,P<0.05差异有统计学意义。结果本次研究中208例患者均获得确切随访,无失访病例。其中复发、转移28例(13.5%),无转移复发180例(86.5%),患者5年无病生存率为86.5%;将单因素分析结果具有统计学意义的变量纳入Cox多因素回归模型。结果显示,年龄<45岁、组织学分级为III级、术后放疗、Ki-6≥30%为行改良根治术T1-2N1M0期乳腺癌患者复发转移的独立预后因素(P<0.05)。结论年龄<45岁、组织学分级为III级、术后放疗、Ki-67≥30%是T1-2N1M0期乳腺癌患者行改良根治术后复发转移的独立危险因素,增加患者预后风险。

Objective To investigate the risk factors of disease-free survival rate after modified radical mastectomy in patients with T1-2N1M0 stage breast cancer.Methods Retrospective analysis were performed in 208 patients with T1-2N1M0 breast cancer underwent modified radical mastectomy from January 2011 to November 2014.The endpoint of follow-up was November 2019 and 5-years survival,of patients metastasis and recurrence of tumors were analyzed,Statistical analysis were performed by using SPSS 22.0 software.Count data were expressed as%and were analyzed by usingχ^2 test.The univariate and Cox multivariate regression models were used to analyze the risk factors of prognosis.A P value<0.05 was considered as statistically significant difference.Results In this study,208 patients were followed up.Among them,28 cases had metastatic or recurrence,180 cases had no metastasis and recurrence,with the 5-year disease-free survival rate of 86.5%.The results of single factor analysis showed that the risk factors of prognosis of patients with T1-2N1M0 breast cancer undergoing modified radical mastectomy included age of<45,Histological grade III,postoperative radiotherapy and Ki-67≥30%,with statistically significant difference(P<0.05).Conclusion Age of<45y,histological grade III,postoperative radiotherapy and Ki-67≥30%are independent risk factors for recurrence and metastasis after modified radical mastectomy in patients with T1-2N1M0 stage breast cancer,which might increase the prognosis risk.