35例妊娠期乳腺癌临床病理特征及预后分析

Clinicopathological Characteristics and Prognosis of 35 Cases of Pregnancy-associated Breast Cancer

目的通过与非妊娠期乳腺癌(non-PABC)比较分析妊娠是否影响妊娠期乳腺癌(PABC)患者的生存。方法回顾性分析PABC患者资料,对PABC病例按TNM分期、分子分型、发病年龄和诊断时年份与non-PABC病例进行1:2配对。Kaplan-Meier法分析无病生存期(DFS)和总生存期(OS),Log rank检验进行比较。Cox多因素分析评估影响PABC预后的危险因素。结果PABC组纳入35例患者(妊娠10例;产后一年内25例),non-PABC组纳入70例患者。中位随访时间分别为68.5和70.7月。PABC组5年DFS为51.6%,non-PABC组为72.8%(χ^(2)=4.72,P=0.029);PABC组和non-PABC的5年OS相似(χ^(2)=1.769,P=0.183)。Cox多因素分析显示妊娠是影响PABC患者DFS的独立危险因素(P=0.011)。结论妊娠期乳腺癌复发风险高,有必要通过进一步研究以便更早期发现妊娠期乳腺癌,并采取干预措施来提高治疗效果。

Objective To assess whether pregnancy affects the survival of pregnancy-associated breast cancer(PABC),compared with non-PABC.Methods We retrospectively analyzed the data of PABC patients.PABC cases and non-PABC cases were matched with 1:2 according to T stage,molecular classification,age of onset and year of diagnosis.The Kaplan-Meier method was used to estimate DFS and OS,and Log rank test was used for comparison.Cox regression analysis was used to evaluate the risk factors that affect the prognosis of PABC.Results We enrolled 35 patients in the PABC group(pregnancy:10;postpartum:25),and 70 patients in the non-PABC group.The median follow-up time was 68.5 and 70.7 months,respectively.The 5-year DFS was 51.6%in the PABC group,and that of the non-PABC group was 72.8%(χ^(2)=4.72,P=0.029);the 5-year OS of the PABC group and the non-PABC group were similar(χ^(2)=1.769,P=0.183).Cox regression analysis showed that pregnancy was an independent risk factor for DFS of PABC patients(P=0.011).Conclusion Patients with breast cancer during pregnancy have a higher risk of recurrence.Further research is necessary to diagnose pregnancy-associated breast cancer earlier and adopt measures to improve the curative effect.