单激素受体阳性乳腺癌患者的临床病理特征及预后因素分析

目的分析雌激素或孕激素受体阳性即单激素受体阳性乳腺癌患者的临床病理特征及预后因素，比较两种单激素受体阳性即ER单阳性和PR单阳性乳腺癌患者的不同之处。方法2000年9月至2002年9月在我院就诊的Ⅰ～Ⅲ。期单激素受体阳性乳腺癌患者共112例，分析其临床病理特征及预后因素。结果全组患者5年生存率（OS）为89．0％，5年无病生存率（DFS）为79．8％。COX多因素预后分析显示，腋窝淋巴结转移数目是全组患者的独立预后因素（P=0．003），脉管瘤栓是淋巴结阴性单激素受体阳性患者DFS的独立预后因素（P=0．038）。PR单阳性组年龄≤50岁（P=0．021）以及绝经前患者（P=0．033）显著多于ER单阳性组。PR单阳性组分级3级、肿瘤直径〉2cm、脉管瘤栓者的比例略高于ER单阳性组，但无统计学意义。内分泌治疗可显著改善ER单阳性组患者的OS（P=0．04）及DFS（P=0．000）。内分泌治疗有一定程度上提高了PR单阳性组患者的OS（P=0．271）及DFS（P=0．387）。结论腋窝淋巴结转移数目是全组患者的独立预后因素。内分泌治疗可显著改善ER单阳性组患者的生存，有改善PR单阳性组患者生存的趋势。

Clinical characteristics and prognostic factors of single hormone receptor positive breast cancer patients

Objective To analyze the clinical characteristics and potential prognostic factors of single hormone receptor positive breast cancer patients, and to identify the differences between the ER^＋ PR^- and ER^- PR^＋ subgroups. Methods 112 single hormone receptor positive breast cancer patients from Sept 2000 to Sept 2002 in our hospital were retrospectively analyzed using SPSS13.0 software. Results The 5- year overall survival rate（OS） and 5-year disease-free survival rate（DFS） were 89. 0% and 79. 8% for all patients, respectively. After the multi-variate COX regression analysis, it was found that the number of axillary lymph nodes with metastasis was the independent prognostic factor for the whole group （ P = 0. 003 ）, and the lymphovascular invasion was the independent prognostic factor for DFS of lymph node negative patients （P = 0. 038）. More premenopausal patients and the patients less than 50 years old （P = 0. 021 ） were in ER^- PR^＋ subgroup than in ER^＋ PR^- subgroup （ P = 0. 033 ）. The proportion of patients with grade 3, tumor size larger than 2cm and with lymphovascular invasion were slightly higher in ER^-PR^＋ group than in ER^＋ PR^- group. Endocrine therapy could significantly improve the OS （P =0. 04） and DFS （P =0. 000） of patients in ER^＋ PR^- group, Conclusions Axillary lymph node status was the independent prognostic factor. Endocrine therapy could significantly improve the survival of ER^＋ PR^- patients.