男性乳腺癌患者的预后影响因素分析

目的：分析有关男性乳腺癌的预后因素以及适合的治疗方式。方法：提取 SEER 数据库2010年有完整随访资料的男性乳腺癌患者的数据。应用 Log －rank 检验并绘制生存曲线分析男性乳腺癌的预后影响因素。结果：475例乳腺癌患者中，111例死亡，其平均生存时间为40．468月。大多数患者为 II －III 期，已经有了恶变的趋势。多数患者 ER（92．4％），PR（85．1％）为阳性，HER －2（76．4％）阴性。发生远处转移的患者仅有42人（8．8％）。22．5％的患者选择了放射治疗，88．2％的患者选择了手术治疗。Log －rank 检验显示不同肿瘤大小、淋巴结情况、远处转移、分期、是否手术、ER、PR、HER －2等的男性乳腺癌患者生存期不同。而是否放射治疗对生存的影响没有统计学意义（P ＞0．05）。COX 回归显示 PR、ER 为生存期的影响因素（P ＜0．05）。结论：ER、PR 均为保护因素，男性乳腺癌患者 HER －2阳性率较低为其调控提供了新的线索。应给予淋巴结浸润的患者更加积极的综合治疗方式；放射治疗不能带来更好的生存期，因此不推荐临床应用。

Prognostic analysis in male breast cancer patients

Objective:To investigate prognostic factors and appropriate treatment in male breast cancer patients considering overall survival(OS).Methods:By Kapaln -Meier method,Log -rank test and Cox regression model to analyze contributing factors in OS about male breast cancer patients.Results:Total of 475 patients were identified from seer database,and 111 died due to breast cancer with an average OS of 40.468 months.Most patients were in 2-3 stages and have a propensity for malignancy.92.4% were ER positive,85.1%were PR positive and 76.4% were HER -2 negative.8.8% experienced metastasis:22.5% chose radiation and 88.2% underwent surgery.Single -var-iate log rank analysis indicated that tumor size,lymph node status,metastasis,grade,surgery,ER,PR,HER -2 signifi-cantly correlated to OS.COX regression model suggested that ER,PR were independent factors for OS.Conclusion:ER,PR were protecting factors.However,lower frequency of HER -2 in male patients suggests novel clues for TNBC patients.More positive treatment should be given for lymph node infiltrating patients,and radiation is not recommen-ded.