男性与女性乳腺癌预后因素的生存分析

目的 分析男性乳腺癌(BC)与女性乳腺癌患者配对资料的临床病理学特征,比较两组患者的生存差异,探讨男性BC患者术后临床预后的影响因素.方法 收集1982年9月至2006年12月天津医科大学附属肿瘤医院收治的45例可手术男性BC患者的临床病理资料,按1∶2的比例与女性BC患者配对,匹配条件为年龄、确诊时间、临床分期和病理类型相似.回顾性分析两组患者的临床病理学特征、复发转移及生存情况.采用SPSS16.0统计软件进行分析.频数资料组间比较采用x2检验.临床病理指标单因素分析采用Kaplan-Meier法,组间曲线比较采用Log-Rank检验,取P＜0.05为差异有统计学意义.结果 45例男性BC与90例女性BC患者配对后,两组患者的中位发病年龄分别为59(26～75)岁和57(22～76)岁,中位随访期分别为61(5～262)个月和71(29～283)个月.男性BC患者的肿物位置、受体情况、辅助治疗及内分泌治疗与女性BC患者相比,差异有统计学意义.单因素分析结果 显示影响男性BC患者预后的因素有肿物大小、淋巴结状况和TNM分期.男性BC和女性BC组患者的5年无病生存率分别为62.3%和78.8%,10年无病生存率分别为35.3%和45.3%;5年总生存率分别为70.5%和82.5%,10年总生存率分别为42.8%和62.4%,两组之间差异有统计学意义.结论 在发病年龄、诊断时间、临床分期及病理类型匹配的条件下,男性BC组的5年和10年无病生存率和总生存率均明显低于女性BC组.应提高对男性BC的重视程度,做到早期发现、早期诊断、早期治疗,并重视手术治疗后的辅助化疗及内分泌治疗,以提高男性BC患者的生存率.

Male breast cancer: a pairing comparison of survival with women breast cancer

Objective To investigate clinicopathological characteristics of male breast cancer patients and women breast cancer patients, compare disease-free survival and overall survival in a group of matched men and women with breast cancer. Methods The clinical data and survival status of 45 cases operable male breast cancer treated in our hospital from 1982. 9 to 2006. 12 were collected. Each man with breast cancer recorded in the database was matched with two women. Matching was done based on age, year of diagnosis, stage and pathology. SPSS16. 0 software was used for statistic treatment. Chi-square test was used for the comparison of frequency data between groups. Kaplan-Meier method was applied to analyze survivals. And Log-Rank was used to compare curves between groups. Statistical significance was considered at P ＜ 0. 05. Results The 45 male breast cancer patients were matched with 90 female patients. The median age at diagnosis was 59 (26 ～ 75 ) years for men and 57 (22 ～ 76) years for women. The median follow-up was 61(5 ～262) months for men and 71 (29 ～283) months for women. Mass location, receptor status, chemotherapy and hormonal therapy were statistically significant between male BC and female BC groups. About male BC patients, monofactorial analysis showed tumor size, lymph node state and TNM stage were prognostic factors. The 5-year disease-free survival of male BC and women BC were respectively 62. 3% and 78. 8%, 10-year DFS were 35.3% and 45.3% ;The 5-year overall survival of male BC and female BC were respectively 70. 5% and 82. 5% ,10-year OS were 42. 8% and 62. 4%. Conclusions After the matching of age, year of diagnosis, stage and pathology, the prognosis for men with breast carcinoma is significantly poor comparing with women. We should play more emphasization on early diagnosis and early therapy, and think highly of chemotherapy and hormonal therapy to improve the prognosis of male BC patients.