74例乳腺癌骨转移的临床预后因素分析

目的:探讨乳腺癌骨转移的临床特征并分析其预后因素。方法:回顾74例乳腺癌骨转移好发部位、病灶特点、发生时间、激素受体分布情况等并用COX比例风险模型进行乳腺癌骨转移预后因素分析。结果:乳腺癌骨转移好发部位在胸部与脊柱,尤其是肋骨和腰椎,几乎均为溶骨性病灶。骨转移平均发生时间为术后33.4个月。骨转移患者中激素受体阳性率比例较高。COX比例风险模型分析显示雌激素受体状况、病理类型和初发单/多发骨转移情况是影响乳腺癌骨转移预后的独立因素。结论:雌激素受体状况、病理类型和初发单/多发骨转移情况是影响乳腺癌骨转移预后的独立因素。对乳腺癌骨转移规律的认识有助于临床诊断和治疗。

The clinical prognostic factors in 74 cases of bone metastases of breast cancer

Objective:To study the clinical characteristics, as well as prognostic factors of bone metastases of breast cancer. Methods: Review the most common site of bone metastases and characteristics, time of occurring bone metastases, the distribution of hormone receptors etc in breast cancer patients.The prognostic factors of the 74 patients who were bone metastases of breast cancer were analyzed by Cox proportional hazard regression model. Results: In a review of the history records of 74 patients, the most common sites of bone metastases were the chest and spine, especially the rib and lumbar vertebrae; almost all of the bone metastases tended to be osteolytic. The mean time of bone metastases was 33.4 months after the surgical procedure. There was a higher hormone receptor-positive proportion in patients with bone metastases. Cox proportional hazard regression model indicated that the status of estrogen hormone receptors , pathological type , and the patients with solitary or multiple skeletal metastases of breast cancer were the independent prognostic factors (P<0.05). Conclusion: The status of estrogen hormone receptors, pathological type, and the patients with solitary or multiple skeletal metastases of breast cancer are the independent prognostic factors for bone metastases of breast cancer. Bone metastases of breast cancer has its unique clinical characteristics, which can direct diagnose and therapy.