2012—2014年全国多中心术后复发三阴性乳腺癌临床流行病学研究

A Multicenter Clinical Epidemiological Study of Recurrent Triple-negative Breast Cancer after Surgery from 2012 to 2014

[目的]探讨术后复发三阴性乳腺癌(triple-negative breast cancer,TNBC)临床流行病学特征。[方法]本研究是一项基于医院的、全国多中心、3年(2012—2014年)临床流行病学回顾性研究。纳入术后复发乳腺癌患者病例资料,收集并分析其人口统计学信息、潜在危险因素、临床诊疗特点及预后信息。[结果]共纳入术后复发TNBC患者455例,平均年龄46岁,中位无病生存时间20个月。相较非TNBC,TNBC在无病生存时间、肝转移、肺转移、骨转移、辅助化疗和分布地区上均有统计学差异(P均<0.05)。多因素分析显示,淋巴结转移数目大于2(OR=0.817,95%CI:0.678~0.985,P=0.034)和新辅助化疗未达病理完全缓解(OR=0.757,95%CI:0.609~0.942,P=0.012)是术后复发TNBC无病生存时间的独立影响因素。[结论]淋巴结转移数大于2和新辅助化疗未达病理完全缓解的TNBC患者,术后应进行密切随访。

[Objective] To explore the clinical epidemiological features of recurrent triple-negative breast cancer(TNBC) after surgery. [Method] This was a hospital-based, nation-wide, and multi-center3-year(2012~2014) retrospective clinical epidemiological study. The data of 3141 patients with recurrent breast cancer after surgery were included, including 455 cases of TNBC. The demographic information, potential risk factors, clinical diagnosis and treatment features, and prognostic information of patients were collected and analyzed. [Results] The average age was 46 years and a median disease-free survival time(DFS) was 20 months for 455 cases of TNBC. There were significant differences in DFS,liver metastasis, lung metastasis, bone metastasis, adjuvant chemotherapy and regional distribution area between non-TNBC and TNBC cases(all P<0.05). Multivariate analysis showed that the number of lymph node metastases >2(OR=0.817, 95%CI:0.678~0.985, P=0.034) and non-p CR after neoadjuvant chemotherapy(OR=0.757, 95%CI:0.609~0.942, P=0.012) were the independent factors affecting DFS of recurrent TNBC after surgery. [Conclusion] Lymph node metastases >2 and non-p CR after neoadjuvant chemotherapy are associated with shorter interval of recurrence and metastasis in TNBC patients after surgery in China.