乳腺导管癌进展后预后的相关因素研究

Research on Related Factors for Prognosis of Progressive Breast Ductal Carcinoma

目的探讨乳腺导管癌进展后影响其预后的相关因素。方法回顾性分析142例乳腺导管癌患者的临床资料,采用Kaplan-Meier法评价患者的生存情况,对影响乳腺导管癌进展后预后的相关因素进行Log-rank检验单因素分析和Cox比例风险模型多因素分析。结果 142例患者均发生复发或转移,局部复发75例,复发率52.8%,肺转移72例,骨转移54例,肝转移43例,脑转移22例,1、3、5年生存率分别为84.5%、62.7%、43.7%。单因素分析结果表明,ER、PR、c-erb B-2、分化程度、淋巴结转移情况、肿瘤复发情况、肿瘤转移情况、肿瘤大小、临床分期、治疗方式是影响患者预后的危险因素(P<0.05),多因素分析结果表明,ER阳性、低分化、淋巴结转移、肿瘤复发、多器官转移是影响患者预后的独立危险因素(P<0.05)。结论对于进展的乳腺导管癌患者,ER状态、分化程度、淋巴结转移情况、肿瘤复发转移是影响其预后的独立危险因素,临床应根据上述因素判断患者预后并选择适当的治疗方式。

Objective To investigate the factors affecting prognosis of breast ductal cancer in progression.Methods Retrospective analysis of clinical data of 142 cases of breast ductal carcinoma was conducted,and Kaplan-Meier method was used to evaluate the patient’s survival,Log-rank test single factor analysis and multivariate Cox proportional hazards model were used to investigate factors affecting the prognosis of breast ductal cancer.Results 142 cases all had recurrence or metastasis,and there was 75 cases of local recurrence,the recurrence rate was 52.8%.there was 72 cases of lung metastasis,54 cases of bone metastasis,43 cases of liver metastasis,22 cases of brain metastasis.1-,3-,and 5-year-survival rates were 84.5%,62.7%,and 43.7%.Univariate analysis showed that ER,PR,c-erb B-2,differentiation,lymph node metastasis,tumor recurrence,tumor metastasis,tumor size,clinical stage,treatment were the risk factors affecting prognosis of patients(P < 0.05),multivariate analysis showed that ER-positive,poorly differentiation,lymph node metastasis,tumor recurrence,multi-organ metastasis were independent risk factors affecting prognosis(P < 0.05).Conclusion For patients with breast ductal cancer in progression,ER status,degree of differentiation,lymph node metastasis,tumor recurrence and metastasis are independent risk factors affecting prognosis,we should determine and choose the appropriate treatment based on these factors.