T1a期浸润性乳腺癌预后影响因素分析

探讨T1a期浸润性乳腺癌预后的影响因素。收集我院2015年1月—2019年1月收治的150例T1a期浸润性乳腺癌患者的临床资料,对影响治疗后复发转移的因素进行分析。150例患者中,6.67%(10/150)患者出现复发转移,其中胸壁局部复发3例,远处转移7例。Logistic回归分析,发现年龄35岁、ER阴性、PR阴性、HER-2阳性与T1a期浸润性乳腺癌治疗后复发转移有关(P0.05)。年龄35岁、ER阴性、PR阴性、HER-2阳性为T1a期浸润性乳腺癌患者治疗后复发转移的危险因素。     

IA期乳腺癌临床病理特征及预后相关因素分析

目的：探讨IA期乳腺癌患者的临床病理特征与预后因素。 方法：回顾性分析2004年1月—2009年12月天津医科大学肿瘤医院收治的156例IA期（T1N0M0,）乳腺癌患者的临床病理资料。 结果：156例患者均为女性;病理类型以浸润性导管癌为主（115例,73.7%）;原发肿瘤大小以T1c居多 （77例,49.4%）;组织学分级以II级（79例,50.6%）及III级（58例,37.2%）为主。5年无进展生存（PFS）为93.3%,5年总生存（OS）为99.1%。单因素分析结果显示,组织学分级、Ki-67表达及淋巴脉管侵犯与患者的PFS有关（均P<0.05）;多因素分析显示,组织学分级及Ki-67表达情况是影响患者PFS的独立预后因素（均P<0.05）。 结论：IA期乳腺癌患者虽然总体预后较好,但对于某些亚组患者而言,预后较差,该类患者的复发转移风险较大。     

三阴性乳腺癌的临床病理特征和预后影响因素分析

目的：探讨三阴性乳腺癌(TNBC)的临床病理特征和预后影响因素。 方法：回顾性分析2008年1月—2013年6月期间收治的并有完整临床病理资料的508例乳腺癌患者，患者分为TNBC组（105例）与非TNBC组（403例），对TNBC的临床病理特征与预后影响因素进行分析。 结果：TNBC组出现局部复发和远处转移患者54例（51.4%），其中死亡11例；非TNBC组出现局部复发和远处转移患者24例（6.0%），TNBC组总体转移率高于非TNBC组（P<0.05）；且TNBC组肝、肺、脑转移率均显著性高于非TNBC组（P<0.05），而骨转移率低于非TNBC组（P<0.05）。Kaplan-Meier 曲线显示，TNBC组前5年DFS及OS均差于非TNBC组，而三阴性亚群5年后DFS及OS较非三阴性亚群好，非TNBC组总生存率高于TNBC组（58.4% vs. 47.4%）（P=0.041）；免疫组化结果显示肿瘤大小（RR=5.5）和淋巴结状态（RR=8.7）均是影响预后的独立危险因素。 结论：TNBC是一种特殊类型的乳腺癌亚型，具有发病年龄小、家族史、有淋巴结转移等特点，其较早发生局部复发和远处转移，肿瘤直径、淋巴结状态是影响预后的独立危险因素。

     

Ⅰ_A期乳腺癌临床病理特征及预后相关因素分析

目的:探讨Ⅰ_A期乳腺癌患者的临床病理特征与预后因素。方法:回顾性分析2004年1月—2009年12月天津医科大学肿瘤医院收治的156例IA期(T1N0M0,)乳腺癌患者的临床病理资料。结果:156例患者均为女性;病理类型以浸润性导管癌为主(115例,73.7%);原发肿瘤大小以T1c居多(77例,49.4%);组织学分级以II级(79例,50.6%)及III级(58例,37.2%)为主。5年无进展生存(PFS)为93.3%,5年总生存(OS)为99.1%。单因素分析结果显示,组织学分级、Ki-67表达及淋巴脉管侵犯与患者的PFS有关(均P0.05);多因素分析显示,组织学分级及Ki-67表达情况是影响患者PFS的独立预后因素(均P0.05)。结论:IA期乳腺癌患者虽然总体预后较好,但对于某些亚组患者而言,预后较差,该类患者的复发转移风险较大。     

原发性肝细胞癌肝移植预后相关因素的单中心研究

目的了解原发性肝细胞癌（PHC）患者肝移植术后的临床病理因素和生存情况,分析影响其预后的危险因素。 方法回顾性分析2015年1月至2016年12月中山市人民医院29例PHC肝移植患者临床资料,统计患者病理特征、围手术期效果和临床结局。对随访资料采用寿命表及Kaplan-Meier方法绘制生存曲线进行生存分析,筛选差异变量纳入Cox回归模型分析,研究影响PHC肝移植患者预后相关因素。 结果29例PHC患者中采取经典原位肝移植25例,背驮肝移植4例。中位随访时间为23个月,失访3例,7例死于复发,生存时间为676.5（26~1 188）d,生存率为73.1%（19/26）。Cox回归分析结果显示,病理分级（P=0.018,95%CI:1.758~361.593）及淋巴结转移（P=0.003,95%CI：0.019~0.438）是影响26例患者预后生存的危险因素,病理分级每升高1级,其预后风险降低0.092倍,淋巴结转移患者预后风险升高25.216倍。 结论肿瘤病理分级、淋巴结转移是影响PHC肝移植预后的重要因素。判断PHC肝移植预后,需要考虑患者淋巴结转移情况以及术后病理生理改变。     

HER-2 0表达与HER-2低表达早期乳腺癌的长期预后与分子特征比较

背景与目的 新型抗人表皮生长因子受体2（HER-2）抗体偶联药物（ADC）为包括HER-2低表达在内的乳腺癌患者开辟了新的治疗选择。然而,目前HER-2低表达和HER-2 0表达乳腺癌之间的临床病理特征、分子特征及预后差异尚不明确。因此,本研究主要比较HER-2低表达和HER-2 0表达乳腺癌患者的生存预后、临床病理特征以及分子特征之间的差异,旨在进一步揭示HER-2低表达乳腺癌的分子特征及更精准地选择ADC药物获益人群。方法 回顾性分析中南大学湘雅医院2011年1月—2015年12月1 245例经手术治疗的Ⅰ~Ⅲ期早期原发性浸润性乳腺癌患者资料。比较不同HER-2表达水平（0表达、低表达、过表达）患者临床病理特征的差异,分析患者的总生存（OS）和无病生存（DFS）的差异,筛选预后的独立影响因素。通过TCGA数据库分析比较HER-2低表达和HER-2 0表达乳腺癌患者的分子特征及免疫微环境差异。结果 1 245例患者中,HER-2 0表达395例（31.73%）、HER-2低表达562例（45.14%）,HER-2过表达288例（23.13%）。与HER-2 0表达患者相比,HER-2低表达患者淋巴结分期更高、激素受体（HR）阳性比例更高、腋窝淋巴结转移更多,Ki-67水平较低（均P<0.05）。生存分析显示,HER-2过表达患者的OS与DFS均明显低于HER-2 0表达患者与HER-2低表达患者（均P<0.05）;HER-2 0表达和HER-2低表达患者的OS和DFS无论在整体上还是不同淋巴结状态或不同HR状态分层患者中均无明显差异（均P>0.05）。多因素Cox风险模型结果提示,年龄、腋窝淋巴结转移是乳腺癌患者OS的独立危险因素;年龄、ER状态、HER-2表达水平、腋窝淋巴结转移是乳腺癌患者DFS的独立危险因素（均P<0.05）。分子特征方面,HER-2低表达和HER-2 0表达在分子突变负荷方面无明显差异,但在免疫浸润方面有一定差异,HER-2 0表达乳腺癌的抗肿瘤免疫反应更为活跃。结论 HER-2低表达和HER-2 0表达乳腺癌的病理特征存在一定差异,但HER-2低表达和HER-2 0表达乳腺癌的预后结局相似;HER-2低表达乳腺癌的分子特征具有异质性,但与HER-2 0表达乳腺癌的分子特征不具有显著特异性。因此,本研究结果尚不支持将HER-2低表达作为新的乳腺癌分子分型。     

切缘宽度对原发性肝癌合并微血管侵犯患者并发症及预后的影响

目的探讨解剖性肝切除术不同切缘宽度对原发性肝癌合并微血管侵犯（MVI）患者术后并发症及预后的影响。 方法回顾性选取2016年10月至2018年12月于快速康复外科下行解剖性肝切除术的96例原发性肝癌合并MVI患者病例资料。根据手术切缘宽度分组为宽切缘组（切缘≥10 mm,n=39例）和窄切缘组（切缘<10 mm,n=57例）。观察两组患者术后并发症发生率及并发症分级;Kaplan-Meier生存曲线分析术后无复发生存（RFS）和总生存（OS）情况;COX回归模型分析不同切缘宽度对原发性肝癌合并MVI患者预后生存的影响。 结果宽切缘组患者术后并发症发生率为25.6%,窄切缘组患者并发症发生率为29.8%,两组并发症发生率及并发症Clavien-Dindo分级比较,差异均无统计学意义（P>0.05）。宽切缘组患者术后5年累积RFS为33.3%,累积OS为41.0%;窄切缘组患者术后5年累积RFS为24.6%,累积OS为36.8%。宽切缘组累积RFS高于窄切缘组（Log-Rank χ²=4.029,P=0.045）,两组累积OS差异无统计学意义（Log-Rank χ²=0.837,P=0.402）。肿瘤直径、临床分期Ⅲ-Ⅳ期、肿瘤数目、淋巴结转移、包膜完整性及切缘<10 mm是影响患者术后无复发生存的独立危险因素（P<0.05）;肿瘤直径>5 cm、肿瘤多发灶、淋巴结转移是影响患者总生存的独立危险因素（P<0.05）,术后辅助治疗是保护因素。 结论快速康复外科下解剖性肝切除术中宽切缘对原发性肝癌合并MVI患者术后并发症的发生没有影响,增加切缘宽度能够提高患者术后无复发生存率,但不改善总生存率。     

进展期胰腺癌患者姑息性旁路手术后的预后因素分析

目的：探讨进展期胰腺癌患者接受姑息性旁路手术后的预后影响因素。 方法：回顾2005年5月—2013年6月收治的102例接受旁路手术的进展期胰腺癌患者的临床资料,分析患者术后的生存情况与预后影响因素。 结果：全组患者的中位总生存时间（OS）为8.7个月,生存分析显示,疼痛程度轻微患者中位OS高于疼痛程度严重患者、ASA I/II患者的中位OS高于ASA III级患者、C反应蛋白（CRP）水平正常患者中位OS高于CRP升高患者、无转移患者中位OS高于肝/腹膜转移患者,差异均有统计学意义（均P<0.05）。单因素分析显示,患者的中位OS与疼痛程度、ASA分级、术中失血量、有无肝/腹膜转移、CRP水平、CA19-9水平、白蛋白（ALB）水平有关（均P<0.05）;COX回归多因素分析显示,ASA III级、重度疼痛、CRP≥5 mg/L、肝/腹膜转移为影响患者术后生存的独立危险因素（均P<0.05）。 结论：ASA III级、重度疼痛、高水平CRP及肝、腹膜转移是姑息性治疗的进展期胰腺癌预后不良的指标。

     

208例T1-2N1M0期乳腺癌改良根治术患者无病生存情况的危险因素分析

目的探究行改良根治术的T1-2N1M0期乳腺癌患者无病生存的影响因素。 方法回顾性分析2011年1月至2014年11月经改良根治术治疗208例T1-2N1M0期乳腺癌患者资料,统计术后截止2019年11月患者随访情况,并记录患者术后5年肿瘤转移、复发情况,以SPSS 22.00统计学软件进行数据处理。计数资料用[例(%)]表示,组间比较采用χ²检验;乳腺癌患者预后的相关因素行单因素和Cox多因素回归模型分析,P<0.05差异有统计学意义。 结果本次研究中208例患者均获得确切随访,无失访病例。其中复发、转移28例(13.5%),无转移复发180例(86.5%),患者5年无病生存率为86.5%;将单因素分析结果具有统计学意义的变量纳入Cox多因素回归模型。结果显示,年龄<45岁、组织学分级为III级、术后放疗、Ki-6 ≥30%为行改良根治术T1-2N1M0期乳腺癌患者复发转移的独立预后因素(P<0.05)。 结论年龄<45岁、组织学分级为III级、术后放疗、Ki-67≥30%是T1-2N1M0期乳腺癌患者行改良根治术后复发转移的独立危险因素,增加患者预后风险。     

基于SEER数据库对初诊Ⅳ期乳腺癌患者的转移部位及其预后分析

目的 探讨初诊Ⅳ期乳腺癌患者肿瘤转移部位与预后之间的关系。方法 从SEER数据库中提取2010–2015年期间有完整随访资料的初诊Ⅳ期浸润性乳腺癌女性患者的数据，按照不同转移部位进行分组，采用单因素和多因素Cox分析不同转移部位乳腺癌特异性生存期(breast cancer-specific survival,BCSS)的差异。采用Kaplan-Meier法绘制生存曲线，行log-rank检验分析影响初诊Ⅳ期乳腺癌BCSS的预后因素。结果 本研究共纳入8 407例初诊转移浸润性乳腺癌患者，其中单纯骨转移患者5 619例(66.84%)，单纯肺转移患者1 483例(17.64%)，单纯肝转移患者1 096例(13.04%)，单纯脑转移患者209例(2.49%)。本组患者中位随访时间为22个月，其中与乳腺癌相关死亡4 180例(49.72%)，患者的中位BCSS为39个月。初诊Ⅳ期浸润性乳腺癌转移部位与BCSS显著相关(χ²=151.07,P<0.001)；多因素Cox模型分析结果显示：肝转移[HR=1.34,95%CI为(1.21,1.49),P<0.0...     

lncRNA NEAT1与消化系统恶性肿瘤预后及临床病理特征关系的Meta分析

背景与目的 长链非编码RNA核富集转录本1（lncRNA NEAT1）在多种实体肿瘤中表达失调并与不良预后密切相关,但其与消化系统恶性肿瘤患者预后之间关系仍不明确。因此,本研究通过系统评价及Meta分析探讨lncRNA NEAT1对消化系统恶性肿瘤患者预后的影响及其与临床病理特征之间的关系。方法 在线检索PubMed、Web of Science、Cochrane Library、中国知网和万方数据库,检索时间均从建库至2021年10月18日,收集公开发表的关于lncRNA NEAT1表达与消化系统恶性肿瘤患者预后或临床病理特征之间关系的队列研究,由2名研究者根据纳入和排除标准对文献进行筛选并提取相关数据,采用Stata 12.0软件进行统计学分析。结果 最终共纳入20项研究,2 031例消化系统恶性肿瘤患者。纳入研究的NOS评分均在6~9分之间,其中16项研究报道了总体生存率（OS）,5项研究报道了无病生存率（DFS）,19项研究报道了临床病理学特征。Meta分析结果显示：NEAT1高表达的消化系统恶性肿瘤患者OS（HR=1.66,95% CI=1.41~1.97,P<0.001）和DFS（HR=2.0,95% CI=1.51~2.65,P<0.001）均低于NEAT1低表达或不表达患者。根据生存分析方法、NEAT1表达截取值、样本量和随访时间进行亚组分析结果显示,NEAT1高表达患者的OS均明显降低（均P<0.05）。此外,临床病理特征分析结果显示：较高水平的NEAT1患者的肿瘤直径更大（OR=2.20,95% CI=1.73~2.79,P<0.001）、临床分期更晚（OR=3.10,95% CI=1.95~4.92,P<0.001）、淋巴结转移（OR=1.94,95% CI=1.30~2.90,P=0.001）及远处转移的风险更高（OR=2.58,95% CI=1.88~3.54,P<0.001）,其与患者年龄、性别、肿瘤分化程度及脉管浸润之间无明显关系（均P>0.05）。结论 lncRNA NEAT1高表达是消化系统恶性肿瘤的不利预后因素,且与不良临床病理特征密切相关,有望作为消化系统恶性肿瘤病情监测及预后判断的重要参考指标。     

术前中性粒细胞与淋巴细胞比值对胰腺癌手术患者预后价值的Meta分析

背景与目的：胰腺癌是恶性程度极高的实体恶性肿瘤之一,因早期缺乏症状导致多数患者确诊时已处于局部进展期或晚期。因此,探索术前判断预后的标志物对临床制定诊疗策略至关重要。目前,术前中性粒细胞与淋巴细胞比率（NLR）与胰腺癌患者预后的关系尚存在争议。本研究使用Meta分析方法,探讨术前NLR与胰腺癌患者术后生存获益之间的关系及其预后价值。方法：计算机检索PubMed、Cochrane Library、Web of Science、中国知网、维普及万方数据库收集术前NLR值与胰腺癌患者术后总体生存期（OS）和无病生存期（DFS）关系的研究,检索时限均从建库至2022年3月31日,由两名评价员独立筛选并纳入文献,提取资料并评价纳入研究的偏倚风险后,利用Revman 5.4和Stata 16.0软件对风险比（HR）和95%可信区间（CI）进行合并,并根据异质性选择对应的效应模型。对纳入研究的文献进行敏感度分析,用Egger回归检验判断纳入文献是否存在显著发表偏倚。结果：共纳入25项回顾性研究,4 796例研究对象。研究中有24篇文献报道了NLR与术后OS之间的关系,6篇报道了NLR与术后DFS之间...     

Oncologic Outcomes of Laparoscopy-Assisted Distal Gastrectomy for Gastric Cancer

Background

In both advanced and early gastric cancer with preoperatively suspected lymph node metastasis, extended lymph node dissection is needed to achieve R0. Since extended lymph node dissection is difficult to perform laparoscopically, few reports have reported long-term outcomes in large numbers of patients. The purpose of this study was to investigate oncologic outcomes after laparoscopy-assisted distal gastrectomy (LADG) with extended lymph node dissection.

Methods

Between April 2004 and March 2010, LADG with extended lymph node dissection was performed at our hospital for 880 patients diagnosed with T1N0-1 or T2N0 (N is classified by Japanese topographic classification) gastric cancer in the lower or middle body of the stomach. D2 lymph node dissection was performed for stage IB (T1N1, T2N0) cancers. Modified D2 lymph node dissection was performed for stage IA (T1N0). Overall survival (OS), disease-free survival (DFS), and form of tumor recurrence at 4 years were investigated retrospectively.

Results

Median follow-up was 42 months. The 4-year OS was 98.2 % for all patients. By stage, OS/DFS were 99.0/99.0 % in stage IA patients, 95.9/95.9 % in stage IB, 92.6/92.0 % in stage IIA, and 90.0/92.9 % in stage IIB. A total of 11 patients died, including 4 deaths from recurrence (liver metastasis, n = 1; peritoneal dissemination, n = 2; distant lymph node and bone metastases, n = 1). There is 1 patient is alive with recurrence (liver). Mean time until recurrence was 14 months.

Conclusions

Oncologic outcomes were good in patients with T1N0-1 and T2N0 gastric cancer who underwent LADG with extended lymph node dissection. This approach appears effective for treating T1N0-1 and T2N0 gastric cancer.     

Dose variation and regimen modification of adjuvant chemotherapy in daily practice affect survival of stage I-II and operable stage III Taiwanese breast cancer patients

To assess the effect of a non-standard dose and regimen of adjuvant chemotherapy on the clinical outcome in stage I–II and operable stage III Taiwanese breast cancer patients. Variables studied included treatment variation (regimen and dose of adjuvant therapy), lymph node status, tumor size, histologic grade, and hormone receptor status. Cox's multivariate regression analyses were used to select prognostic factors significant for disease-free survival (DFS) and overall survival (OS). In the multivariate analysis, lymph node-positive, a tumor size greater than 5 cm, grade III, hormone receptor-negative status, and non-standard adjuvant chemotherapy were independent prognostic factors for DFS and/or OS. Node-positive patients treated with standard adjuvant chemotherapy had a significantly better DFS (HR = 0.6; P = 0.032) and OS (HR = 0.54; P = 0.025) than those treated with non-standard adjuvant chemotherapy. Breast cancer patients receiving standard adjuvant chemotherapy have a better DFS and OS than those receiving non-standard adjuvant chemotherapy.     

胚系BRCA突变年轻乳腺癌术式选择对预后影响的Meta分析

背景与目的 携带胚系BReast CAncer基因（gBRCA）突变的年轻乳腺癌患者同时具有年轻与基因突变带来的双重风险。目前对于gBRCA突变早期乳腺癌患者是否可行保乳治疗目前尚无一致结论。本研究通过Meta分析探讨不同手术方式对gBRCA突变的年轻乳腺癌患者预后的影响，以及该影响是否有人种差异。方法 检索多个国外数据库，收集比较gBRCA突变早期乳腺癌患者行保乳手术与全乳切除术预后差异的临床研究，对无复发生存（RFS）、无转移生存（MFS）、乳腺癌特异性生存（BCSS）、总生存（OS）等指标进行Meta分析。结果 最终纳入6篇研究（中国2篇，欧美4篇），共2 140例gBRCA突变患者，中位年龄38~47岁。Meta分析结果显示，总体人群中，gBRCA突变患者行保乳手术较全乳切除术复发风险增高（RFS：HR=1.91，95% CI=1.03~3.54，P<0.05），但两种术式的MFS、BCSS、OS差异均无统计学意义（均P>0.05）；中国人群中，gBRCA突变患者行保乳手术较全乳切除术复发风险增高（RFS：HR=1.63，95% CI=1.10~2.41，P<0.05），两种术式的其余指标差异均无统计学意义（均P>0.05），欧美人群中，两种术式的上述指标差异均无统计学意义（均P>0.05）。结论 对于欧美人群，保乳手术不是gBRCA突变早期年轻乳腺癌术后预后的风险因素；但在中国人群中，gBRCA突变早期年轻乳腺癌患者行保乳手术可能具有更高的复发风险，需在术式选择的医疗决策时充分告知。     

Outcome of radiotherapy for clinically overt metastasis to the internal mammary lymph node in patients receiving neoadjuvant chemotherapy and breast cancer surgery

PurposeThis study was aimed to assess the outcome of radiotherapy and determine prognostic factors for survival in breast cancer patients with clinically overt metastasis to the internal mammary lymph node (IMN+).MethodsWe retrospectively reviewed the medical records of 193 patients with IMN + breast cancer who received neoadjuvant chemotherapy (NAC), breast surgery without internal mammary lymph node (IMN) dissection, and postoperative radiotherapy at 9 hospitals between 2009 and 2013. Breast-conserving surgery or mastectomy was performed after taxane-based NAC. Radiotherapy was administered to the whole breast/chest wall and regional nodes. IMN-covering radiotherapy was performed in 92.2% of patients with median dose of 58.4 Gy (range, 44.9–69.1 Gy). The overall survival (OS), disease-free survival (DFS), and IMN failure-free survival (IMNFFS) were analyzed.ResultsAfter median follow-up of 71 months, 9 patients (4.7%) developed IMN failure and simultaneous distant metastasis. The 5-year DFS, OS, and IMNFFS was 68.6%, 81.8%, and 95.3%, respectively. Non-triple-negative breast cancer, Ki-67 ≤ 10%, pathological complete response (CR) in tumor and axillary node, and radiologic CR of IMN after NAC were significant factors for predicting higher DFS; however, IMN radiation dose was not significant determinants for DFS. The 5-year DFS of patients with IMN-dose ≤ 50.0 Gy and those with >50.0 Gy was 86.7% and 76.7%, respectively (p = 0.41).ConclusionsA multimodality strategy including NAC, breast surgery, and IMN-covering radiotherapy was effective for patients with overt IMN + breast cancer. Even without an IMN dissection, most patients were IMN failure-free with an IMN-focusing radiotherapy.     

The prognostic significance of metaplastic carcinoma of the breast (MCB) – A case controlled comparison study with infiltrating ductal carcinoma

PurposeMetaplastic carcinoma of the breast (MCB) is a rare histological subtype of breast cancer with an incidence of less than 0.1%–0.5%. Due to its rarity, the clinical characteristics and prognostic significance of MCB compared with other common breast cancers (like infiltrating ductal carcinoma [IDC], and infiltrating lobular carcinoma [ILC]) are not clear, and controversial among different reports.MethodsWe performed a collective comparison study of multi-institutional cases to evaluate the clinical characteristics and prognostic status of MCB to compare with IDC and ILC. A case control analysis was performed to minimize the bias from clinicopathologic factors between IDC and MCB. Disease free survival (DFS) and overall survival (OS) between groups were compared.ResultsForty-five MCB patients were enrolled from the 4 medical centers and compared with 1777 IDC and 53 ILC patients from the CCH cancer registry database comprise the current study. Compared with IDC, MCB was associated with older age, larger tumor size, a lesser lymph node positive rate, a higher likelihood of distant metastasis, higher tumor grade, lower ER-positive tumor, and higher triple negative breast cancer subtype (TNBC). MCB was associated with worse OS (p = 0.031) than IDC, but no difference in DFS (p = 0.071); however, MCB was not statistically different from ILC in both DFS and OS (p = 0.289 and 0.132, respectively). Compared with the case-controlled IDC group, MCB patients had poorer OS (p = 0.040), but no difference in DFS (p = 0.439).ConclusionMCB is associated with poorer OS than IDC, and this was related to tumor behavior rather than clinicopathologic factors.     

保留乳头乳晕复合体的乳腺癌改良根治术预后的相关因素分析

目的探究影响保留乳头乳晕复合体(NAC)的乳腺癌改良根治术(NSM)预后的相关因素。 方法回顾性分析2011年1月至2014年12月84例早期原发性乳腺癌并接受NAC的NSM患者临床病理资料。使用统计软件SPSS 20.0进行数据分析,采用K-M生存曲线评估术后无病生存(DFS)及总生存(OS),采用单因素分析和Cox多因素分析影响NSM术后患者DFS和OPS的影响因素。P<0.05差异有统计学意义。 结果术后局部复发8例,远处转移6例,术后5年DFS为83.3%,OS为91.7%。多因素分析显示,肿瘤最大径、肿瘤距乳头乳晕距离(TND)、腋窝淋巴结状态、组织学类型及Her-2阳性是影响DFS的独立危险因素(P<0.05);而腋窝淋巴结状态是影响术后OS的独立危险因素(P<0.05)。 结论肿瘤最大径、TND、腋窝淋巴结状态、组织学类型及Her-2阳性是DFS的独立危险因素,腋窝淋巴结状态是OS的独立危险因素;腋窝淋巴结情况同时影响患者术后DFS和OS,术前系统、精准地评估并妥善处理特殊腋窝淋巴结可提高乳腺癌患者预后。     

Dual-phase FDG PET/CT for predicting prognosis in operable breast cancer

PurposeWe aimed to investigate the role of dual-phase FDG PET/CT in predicting the prognosis of patients with operable breast cancer.MethodsWe retrospectively reviewed the data of 998 patients who underwent radical treatment for breast cancer. Before treatment, PET/CT scans were performed 1 and 2 h after FDG administration. The maximum standardized uptake value (SUVmax) at both time points (SUVmax1 and SUVmax2) in the primary tumor and the retention index (RI) were calculated. PET recurrence risk (PET-RR) was determined based on the SUVmax1 and RI, and disease-free survival (DFS) and overall survival (OS) were evaluated according to the metabolic parameters. Propensity score matching was performed to adjust for biological characteristics.ResultsThe cut-off values for SUVmax1 and RI were 3 and 5%, respectively. The 5-year DFS was 94.9% and 86.1% (P < 0.001), and the 5-year OS was 97.6% and 92.7% (P < 0.001) in the low and high PET-RR groups, respectively. In multivariate analysis, high T status, nodal metastasis, the triple-negative subtype, and high PET-RR were independent factors of poor DFS. Propensity score matching revealed similar findings (5-year DFS 91.8% vs. 88.6%, P = 0.041 and 5-year OS 97.1% vs. 94.2%, P = 0.240, respectively).ConclusionThe combined parameters of SUVmax1 and RI on dual-phase FDG PET/CT were useful for predicting prognosis of patients with breast cancer. Patients with a high SUVmax1 and a negative time course of FDG uptake had a favorable prognosis.     

ǰ���ܰͽ�����Luminal B���������ٰ���ǰ��Ҹ���ܰͽ�״̬��Ԥ��Ӱ���о�

??Effect of non-sentinel lymph node status on prognosis of Luminal B (HER2 negative) early breast cancer with positive sentinel lymph nodes YE Jing-ming*, XU Ling, LIU Qian, et al. *Breast Disease Center, Peking University First Hospital, Beijing100034, China
Corresponding author: LIU Yin-hua, E-mail??liuyinhua@medmail.com.cn
Abstract Objective To evaluate the effect of non-sentinel lymph node status on prognosis of Luminal B ??HER2 negative?? early breast cancer. Methods Luminal B ??HER2 negative?? early breast cancer with positive sentinel lymph node treated from January 2008 to December 2014 in Peking University First Hospital entered the retrospective study. The clinicopathological features and their relationship with non-sentinel lymph nodes status were analyzed statistically. The effect of non-sentinel lymph nodes status on prognosis of Luminal B ??HER2 negative?? early breast cancer with positive sentinel lymph nodes were also analyzed. Results In the group of 142 patients with positive sentinel lymph nodes ??SLN???? the average number of SLNs detected in each patient were 2.06±1.26. The number of positive SLNs was associated with the status of non-sentinel lymph nodes?? but not the age?? BMI?? menopause?? T stage?? histological grade?? lympho-vascular invasion. Non-SLN axillary lymph node non-metastasis occurred in 78 patients (54.9%), DFS 93%, OS 93.1%; non-SLN axillary lymph node metastasis occurred in 64 patients (45.1%), DFS 95.2%, OS 91.9%. Based on Log-rank (Mantel-Cox) test, There was no significant difference between two groups in DFS (χ2=0.011, P=0.918) and OS (χ2=0.348, P=0.555) . Conclusion The number of positive sentinel lymph nodes in Luminal B ??HER2 negative?? early breast cancer patients with sentinel lymph nodes metastasis were associated with the status of non-sentinel lymph nodes. There were no statistical differences betweennon-sentinel lymph nodes metastasis group and non-metastasis group in disease free survival and over-roll survival.