乳腺癌骨转移病人危险因素及预后因素分析

Analysis of risk factors and prognosis of patients with bone metastasis from breast cancer

目的分析乳腺癌骨转移病人的危险因素及预后因素。方法收集2013~2015年美国监测、流行病学和最终结果(SEER)数据库中晚期乳腺癌病人,分析骨转移的相关危险因素,采用多因素Cox回归分析影响骨转移病人预后的独立危险因素。结果单因素分析结果显示,在晚期乳腺癌病人中,骨转移与病人性别、年龄、种族、组织分级、病理类型、N分期、肝转移、肺转移、ER状态、PR状态及HER-2状态有关(P<0.05),多因素分析结果显示,骨转移与病人的年龄、性别、组织分级、病理类型、N分期、ER状态、PR状态及HER-2状态有关。晚期乳腺癌病人中骨转移病人的总体生存率较高,多因素Cox回归模型显示,病人发病年龄大、黑人、组织分级高、T分期高、没有进行手术及化疗、伴有脑转移、伴有肺转移、伴有肝转移、ER阴性、PR阴性及HER-2阴性均是影响骨转移病人生存的独立危险因素。结论在晚期乳腺癌病人中,骨转移较非骨转移病人预后好。发病年龄大、黑人、组织分级高、T分期高、伴有脑转移、伴有肺转移、伴有肝转移、ER阴性、PR阴性及HER-2阴性均是其预后差的独立危险因素。

Objective To analyze the risk factors and prognosis of breast cancer patients with bone metastases. Methods Collected 2013-2015 U. S. Surveillance,Epidemiology,and End Results( SEER) database of patients with advanced breast cancer,and analyze the risk factors of bone metastasis,and multivariate Cox regression analysis was used to analyze the independent risk factors affecting the prognosis of patients with bone metastasis. Results Univariate analysis showed that in patients with advanced breast cancer,bone metastasis was related to gender,age,race,histological grade,pathological type,N stage,liver metastasis,lung metastasis,ER status,PR status and HER-2 status Relevant( P <0. 05);the results of multivariate analysis showed that bone metastasis was related to the patient’s age,gender,tissue grade,pathological type,N stage,ER status,PR status,and HER-2 status. The overall survival rate of patients with bone metastases in advanced breast cancer patients is higher;the multivariate Cox regression model shows that the patients are older at onset,black,high tissue grade,high T stage,no surgery and chemotherapy,accompanied by brain metastasis,accompanied by Lung metastasis,liver metastasis,ER negative,PR negative,and HER-2 negative are all independent risk factors affecting the survival of patients with bone metastases. Conclusion Among patients with advanced breast cancer,bone metastasis have a better prognosis than non-bone metastases. The age of onset,black people,high tissue grade,high T stage,brain metastasis,lung metastasis,liver metastasis,ER negative,PR negative and HER-2 negative are independent risk factors for poor prognosis.