不同复发风险的早期乳腺癌患者临床病理特征及预后影响因素研究

Clinicopathological characteristics and prognostic factors of early breast cancer patients with different recurrence risk

目的 探讨不同复发风险的早期乳腺癌患者临床病理特征及预后影响因素研究。方法 收集2016-01—2019-10在我院诊治的乳腺癌患者368例,随访至2020-02。根据21基因复发风险评分(RS)将患者分为低风险组248例(RS<18分)和中高风险组(RS≥18分)。收集并分析两组患者临床病理特征、手术、术后序贯治疗及复发转移情况。采用Cox多因素模型分析影响早期乳腺癌患者无复发生存期(RFS)的影响因素。结果 低风险组和中高风险组在病理分期、Ki-67表达、术后化疗、内分泌治疗上有显著性差异(P均<0.05);患者随访时间为14~65个月,中位随访时间为34.0个月,局部复发患者16例,远处转移患者6例,其中低风险组局部复发患者6例,远处转移患者1例,中高风险组局部复发患者10例,远处转移患者5例;与低风险组相比,中高风险组RFS差异有统计学意义(Log rank=14.590,P<0.001);采用Cox模型分析示,21基因RS评分、病理分期、Ki-67表达和化疗影响患者无复发生存时间的独立影响因素(P均<0.05)。结论 不同复发风险早期乳腺癌患者与临床病理特征相关,21基因RS评分是影响乳腺癌预后的独立因素。

Objective To investigate the clinicopathological characteristics and prognostic factors of early breast cancer patients with different recurrence risk. Methods A total of 368 patients with breast cancer diagnosed and treated in our hospital from January 2016 to October 2019 were collected and followed up to February 2020;According to the 21 gene recurrence risk score(RS), the patients were divided into low risk group(248 cases)(RS <18 points) and medium high risk group(RS≥18 points). The clinicopathological characteristics, surgical procedures, postoperative sequential treatment, and recurrence and metastasis of patients in the two groups were collected and analyzed;Cox multivariate model was used to analyze the influencing factors of relapse-free survival(RFS) in patients with early breast cancer. Results Between the low risk group and high risk group, the pathological staging, expression of Ki67, postoperative chemotherapy, endocrine therapy were significant difference(P<0.05);Patients were followed up for 14 ~ 65 months, the median follow-up time of 34.0 months, 16 patients had local recurrence and distant metastasis;6 patients had local recurrence and one patient had distant metastasis in the low risk group;in high risk group 10 patients had local recurrence and 5 patients had distant metastasis;compared with low risk group, the high-risk group of RFS difference was statistically significant(Log rank = 14.590, P<0.001);Cox model analysis showed that RS score of 21 gene, pathological stage, Ki67 expression and chemotherapy were independent factors affecting the survival time free of recurrence(all P<0.05). Conclusion Patients with different recurrence risk of early breast cancer are correlated with clinicopathological characteristics. RS score of 21 gene is an independent factor affecting the prognosis of breast cancer.