289 例Luminal B 型乳腺癌患者预后的相关因素分析

目的探讨Luminal B型乳腺癌患者预后的影响因素。方法收集2015年1月—2016年12月我院收治的289例Luminal B型乳腺癌患者的临床及随访资料,对血小板/淋巴细胞比值(PLR)、红细胞体积分布宽度(RDW)行受试者工作特征(ROC)曲线分析,计数资料采用χ^2检验及Fisher确切概率法,Kaplan-Meier法绘制生存曲线,组间比较采用Log-rank检验,预后分析采用COX多因素回归模型。结果高、低PLR组乳腺癌患者的无病生存率(DFS)分别为82%(77/94)、94.9%(185/195),高、低RDW组乳腺癌患者DFS分别为85.3%(139/163)、97.6%(123/126)。单因素分析显示,生育史、腋窝淋巴结、病理分期、脉管癌栓、PLR、RDW、辅助化疗、内分泌治疗是影响Luminal B型乳腺癌患者预后的危险因素(P<0.05)。COX多因素分析显示,生育史、RDW、辅助化疗、内分泌治疗是影响Luminal B型乳腺癌患者预后的独立危险因素(P<0.05)。结论Luminal B型乳腺癌术前RDW测定具有一定的预测价值,RDW升高可提示预后不良;无生育史或首次生育年龄≥35岁的Luminal B型乳腺癌患者复发风险较高。

Prognostic Factors of 289 Patients with Luminal B Breast Cancer

Objective To explore the prognostic factors of patients with luminal B breast cancer.Methods The clinical and follow-up data of 289 patients with luminal B breast cancer between January 2015 and December 2016 were collected.The platelet-to-lymphocyte ratio(PLR)and red blood cell volume distribution width(RDW)were analyzed by receiver operating characteristic(ROC)curve.Comparison of the counting data was examined by Chi square test and Fisher exact probability method.The survival curve was drawn by Kaplan-Meier method.The Log-rank test and Cox multivariate regression model were used for prognosis analysis.Results The disease-free survival(DFS)of high PLR group and low PLR group were 82%(77/94)and 94.9%(185/195)respectively.The DFS of high RDW group and low RDW group were 85.3%(139/163)and 97.6%(123/126)respectively.The results of univariate analysis showed that pregnancy history,axillary lymph nodes,pathological stage,vascular cancer thrombus,PLR,RDW,adjuvant chemotherapy and endocrine therapy were the risk factors for the prognosis of luminal B breast cancer(P<0.05).Cox multivariate analysis showed that pregnancy history,RDW,adjuvant chemotherapy and endocrine therapy were independent risk factors for the prognosis of luminal B breast cancer patients(P<0.05).Conclusion The preoperative RDW measurement had a certain predictive value for luminal B breast cancer patients.The increase of RDW indicated the poor prognosis.No pregnancy history or the age of first birth≥35 years could increase the risk of recurrence in patients with luminal B breast cancer.