乳腺浸润性导管癌保乳术后局部复发的影响因素分析

An analysis of influencing factors for local recurrence of invasive ductal carcinoma after breast conserving surgery

目的探讨乳腺浸润性导管癌患者保乳术后局部复发的影响因素。方法回顾性分析接受保乳术治疗的143例乳腺浸润性导管癌患者的临床病理及预后资料。分析不同发病年龄、分子分型、组织学分级、肿瘤直径、腋窝淋巴结状态和临床分期与患者保乳术后局部复发的关系。结果143例患者中位随访时间为68个月,复发患者11例(7.69%),未复发患者132例(92.31%)。患者中位局部复发时间为33个月,术后5年和8年局部复发率分别为5.59%和7.69%。不同发病年龄、肿瘤直径、腋窝淋巴结状态患者局部复发率比较差异有统计学意义(P<0.05),而不同TNM临床分期、分子分型、组织学分级患者局部复发率比较差异无统计学意义(P>0.05)。Cox多因素回归分析结果显示,发病年龄≤35岁是乳腺浸润性导管癌保乳术后局部复发的独立危险因素,肿瘤直径≤20 mm则是其保护因素(P<0.05)。结论乳腺浸润性导管癌患者保乳术后局部复发与发病年龄、肿瘤直径和腋窝淋巴结状态有关,发病年龄和肿瘤直径是影响术后局部复发的独立因素。

Objective To explore the influencing factors of local recurrence in the patients with breast invasive ductal carcinoma after breast conserving surgery.Methods The clinical pathologic and prognostic data of 143 patients with breast invasive ductal carcinoma underwent breast conserving surgery were retrospectively analyzed.The relationship between local recurrence after breast conserving surgery and different age of onset,molecular types,histological grade,tumor diameter,axillary lymph node status and clinical stage was analyzed.Results The median follow-up time of 143 patients was 68 months,during which 11 patients(7.69%)were with recurrence and 132 patients(92.31%)were without recurrence.The median time of recurrence was 33 months.The local recurrence rate of 5 and 8 years after surgery were 5.59%and 7.69%.There were statistically significant differences in the local recurrence rate among the patients with different age of onset,tumor diameter and axillary lymph node status(P<0.05),but there were no statistically significant differences of the local recurrence rate among the patients with different TNM clinical stages,molecular types and histological grades(P>0.05).Cox multivariate regression analysis showed that the age≤35 years old was the independent risk factor for the local recurrence of breast invasive ductal carcinoma after breast conserving surgery and the tumor diameter≤20 mm was the protective factor for that(P<0.05).Conclusion The local recurrence of breast invasive ductal carcinoma in the patients after breast conserving surgery is related to the age of onset,tumor diameter and axillary lymph node status,of which the age of onset and tumor diameter are the independent factors affecting the local recurrence.